A possible option for those who are struggling to find a TRT specialist.

Buy Lab Tests Online

cocarr

New Member
I was at a loss finding a knowledgeable Dr. to treat me after I found this site and started to educate myself. Prior to finding this site I would have just went with what a Dr. said but the knowledge and information from here changed my view on the matter. I have fairly low T (low 200s) and just recently found this out after years of feeling horrible and not myself. On a whim I asked my Dr's PA to order a Testosterone and Thyroid panel. She ordered only total T and a basic thyroid test and that was it. That was the point I knew they lacked what I needed.

My Dr. is in his early 70s and his PA is near 80. They are both amazing people but obviously out of the loop for something as complex as treating T properly. Rather then refer to a specialist I made another appt. with my Dr. and this time went in armed with a print out of Dr. Crisler's "Testosterone: a recipe for success" and referenced it multiple times during our discussion. I then asked him if he would like to take it and read it so we could get the proper labs ordered and come up with a good game plan. He agreed and called me back today (3-6). He not only read the entire thing but made a copy of it for himself to keep. He was happy to have a starting map/plan as Dr. Crisler had laid out and was also very impressed with how Dr. Crisler explained a how and why for everything that he recommended. He also raved about Dr. Crisler's portion on "finding out why the T is low". It opened his mind to the matter and likely changed how he goes forward with this process for any of his patients from here on out.

He also wants me to leave my copy of Nelsons book with him the next time I go into his office so he can become more knowledgable on the subject. I know many guys wont have a PCP with as low of an ego as I do but for someone who really loves their PCP this option might end up being the best route. If your PCP is receptive and open minded as mine was and does not have a "know it all" mentality maybe you can give him/her the tools they need to better treat you. I know I am far more comfortable with my long time PCP than I would be a new Dr.
 
Defy Medical TRT clinic doctor

Vettester Chris

Super Moderator
In the starting of my journey, my GP (female) knew very little. To the point of wanting to do 1 shot per month type knowledge. The endo she referred me to was worse. However, over the 5 or 6 years of this stuff, my GP now picks my brain quite a bit, because I go outside of my PCP for HRT treatment. When she saw the improvements, she started asking questions. So, I made it a point to start getting very specific, e.g., Not just telling her that HCG keeps the testes working, instead I get very specific with the LH mimic analog bit, leydig receptors, and how this factors with my exogenous test protocol.

Basically, communicating in a familiar language brings a level of appreciation to the table. Now, I have her starting to see a whole new perspective with the Thyroid. I'll get her to throw in a prostrate exam, and we both get something out of it!!
 

cocarr

New Member
It is funny how little most practitioners know about TRT. I am a paramedic and have always felt like I could talk "medical" with anyone. That is until my recent tests and I delved deeper into hormones. I can put a 12 lead on someone and break it down better than most cardiologists can. I can decompress a collapsed lung and make a rock have a pulse with meds. For some reason though I am having a really, really hard time grasping all of the information regarding TRT that I find on this site. It really is a complicated process. I even have the luxury of being married to a woman who is literally a "blood genious". My wife is a medical technologist (the one looking at your blood under a microscope). Even so I seem to be struggling to get a grasp on all of this.

Hopefully my Dr.s willingness to read the information I am finding here mixed with what I can absorb will mesh together into something that works for my body. I know that the information I am presenting to him is absorbed allot easier by his smart brain haa. He is a really smart old fella.
 

Gene Devine

Super Moderator
I was at a loss finding a knowledgeable Dr. to treat me after I found this site and started to educate myself. Prior to finding this site I would have just went with what a Dr. said but the knowledge and information from here changed my view on the matter. I have fairly low T (low 200s) and just recently found this out after years of feeling horrible and not myself. On a whim I asked my Dr's PA to order a Testosterone and Thyroid panel. She ordered only total T and a basic thyroid test and that was it. That was the point I knew they lacked what I needed.

My Dr. is in his early 70s and his PA is near 80. They are both amazing people but obviously out of the loop for something as complex as treating T properly. Rather then refer to a specialist I made another appt. with my Dr. and this time went in armed with a print out of Dr. Crisler's "Testosterone: a recipe for success" and referenced it multiple times during our discussion. I then asked him if he would like to take it and read it so we could get the proper labs ordered and come up with a good game plan. He agreed and called me back today (3-6). He not only read the entire thing but made a copy of it for himself to keep. He was happy to have a starting map/plan as Dr. Crisler had laid out and was also very impressed with how Dr. Crisler explained a how and why for everything that he recommended. He also raved about Dr. Crisler's portion on "finding out why the T is low". It opened his mind to the matter and likely changed how he goes forward with this process for any of his patients from here on out.

He also wants me to leave my copy of Nelsons book with him the next time I go into his office so he can become more knowledgable on the subject. I know many guys wont have a PCP with as low of an ego as I do but for someone who really loves their PCP this option might end up being the best route. If your PCP is receptive and open minded as mine was and does not have a "know it all" mentality maybe you can give him/her the tools they need to better treat you. I know I am far more comfortable with my long time PCP than I would be a new Dr.

If you could see the smile on my face and tears in my eyes after reading this you wouldn't believe it:)

I am so happy for you cocarr!

This is precisely why we created ExcelMale.com.

Please keep us posted on your protocol, your results, how you feel...everything as you follow the path of TRT here in this thread.

Just really good stuff man!!!
 

Gene Devine

Super Moderator
It is funny how little most practitioners know about TRT. I am a paramedic and have always felt like I could talk "medical" with anyone. That is until my recent tests and I delved deeper into hormones. I can put a 12 lead on someone and break it down better than most cardiologists can. I can decompress a collapsed lung and make a rock have a pulse with meds. For some reason though I am having a really, really hard time grasping all of the information regarding TRT that I find on this site. It really is a complicated process. I even have the luxury of being married to a woman who is literally a "blood genious". My wife is a medical technologist (the one looking at your blood under a microscope). Even so I seem to be struggling to get a grasp on all of this.

Hopefully my Dr.s willingness to read the information I am finding here mixed with what I can absorb will mesh together into something that works for my body. I know that the information I am presenting to him is absorbed allot easier by his smart brain haa. He is a really smart old fella.

Keep reading and learning and you will get it.

Understanding hormonal loops is not as easy as it sounds...in fact it may be one of the most complex physiological processes in the human body.

Like anything else, the more you read and the more questions you ask the easier it will become.

Read the stickies in the forum and ask questions and we will answer them for you.

The more you learn the empowered you become and the more you will appreciate how wonderful and powerful TRT is for men!
 
I am so glad the paper was of help to you.

FYI: I am releasing the 2014 updated version of my "TRT: A Recipe for Success" in June.

It's got all kinds of new stuff in it (and more than twice as many pages).
 

BigJohn

Member
This website is a god send for most guys. I've educated myself to the point that my doctor takes notes when I come in. Dr Crisler I've pasesd your website on to him on several occasions.
 

Kelly

Member
What a great story cocarr. Great to have a doc that's interested and willing to learn right along with you. That's the partnership all should have!
 

cocarr

New Member
Thanks for all of the responses fellas and Dr. Crisler thank you for your "simple", to the point map. It in and of itself has given me some piece of mind in starting this process and I now know that things will be heading in the right direction.

Taking the first steps I think is the hardest. It was for me anyway. I felt like a dog chasing his tail and even after I found this site and started learning some things I still felt like I had no direction since I had yet to find a specialist. I would have even been more hard pressed to find a specialist who was open to my suggestions. That is where my PCP's open mindedness really saved me. It was a shot in the dark as to rather he would be stubborn or go along with it.

The best part is the information that I read and pass on to him is understood at a whole different level since he is a very smart man. Having been a Dr. since dinosaurs roamed the earth he has to be haa.

Also I went this morning and had my bloodwork drawn. My Dr. ordered everything exactly as Dr. Crisler suggested and even went so far as to find all of the lab numbers in his book so it would be done right. Rather than just order the "sensitive estradiol" he found the code for it so there are no mistakes. I will hopefully have the results back on Monday or Tuesday and I can post them up on the labs thread. Very curious to see where everything else falls.
 

Gene Devine

Super Moderator
Thanks for all of the responses fellas and Dr. Crisler thank you for your "simple", to the point map. It in and of itself has given me some piece of mind in starting this process and I now know that things will be heading in the right direction.

Taking the first steps I think is the hardest. It was for me anyway. I felt like a dog chasing his tail and even after I found this site and started learning some things I still felt like I had no direction since I had yet to find a specialist. I would have even been more hard pressed to find a specialist who was open to my suggestions. That is where my PCP's open mindedness really saved me. It was a shot in the dark as to rather he would be stubborn or go along with it.

The best part is the information that I read and pass on to him is understood at a whole different level since he is a very smart man. Having been a Dr. since dinosaurs roamed the earth he has to be haa.

Also I went this morning and had my bloodwork drawn. My Dr. ordered everything exactly as Dr. Crisler suggested and even went so far as to find all of the lab numbers in his book so it would be done right. Rather than just order the "sensitive estradiol" he found the code for it so there are no mistakes. I will hopefully have the results back on Monday or Tuesday and I can post them up on the labs thread. Very curious to see where everything else falls.


Post your blood work here in this thread complete with ranges.
 
I was at a loss finding a knowledgeable Dr. to treat me after I found this site and started to educate myself. Prior to finding this site I would have just went with what a Dr. said but the knowledge and information from here changed my view on the matter. I have fairly low T (low 200s) and just recently found this out after years of feeling horrible and not myself. On a whim I asked my Dr's PA to order a Testosterone and Thyroid panel. She ordered only total T and a basic thyroid test and that was it. That was the point I knew they lacked what I needed.

My Dr. is in his early 70s and his PA is near 80. They are both amazing people but obviously out of the loop for something as complex as treating T properly. Rather then refer to a specialist I made another appt. with my Dr. and this time went in armed with a print out of Dr. Crisler's "Testosterone: a recipe for success" and referenced it multiple times during our discussion. I then asked him if he would like to take it and read it so we could get the proper labs ordered and come up with a good game plan. He agreed and called me back today (3-6). He not only read the entire thing but made a copy of it for himself to keep. He was happy to have a starting map/plan as Dr. Crisler had laid out and was also very impressed with how Dr. Crisler explained a how and why for everything that he recommended. He also raved about Dr. Crisler's portion on "finding out why the T is low". It opened his mind to the matter and likely changed how he goes forward with this process for any of his patients from here on out.

He also wants me to leave my copy of Nelsons book with him the next time I go into his office so he can become more knowledgable on the subject. I know many guys wont have a PCP with as low of an ego as I do but for someone who really loves their PCP this option might end up being the best route. If your PCP is receptive and open minded as mine was and does not have a "know it all" mentality maybe you can give him/her the tools they need to better treat you. I know I am far more comfortable with my long time PCP than I would be a new Dr.

Congratulations on the education process you've taken with your Doc! You did the same thing I did to educate my HIV Doc. Only difference is that I did this last August before this site was up and running. I'd never heard of Dr. Crisler but I had read both of Nelson's books. I was mostly focused on Built To Survive as I'm living with AIDS. My first thought was to send the Doc a copy of the book but I knew he'd never get a chance to sit down and read it. What I did was make copies of sections that pertained specifically to me. For example I left out information about anabolics because I was lucky enough to never have had wasting syndrome and didn't include info on weight training because he knew I'd been into bodybuilding for years. I put together a concise and very well laid out presentation that ended up being almost half an inch thick. Doing this made me feel like I was back in college doing a big research project and I felt quite proud of it when I was finished! When I told the Doc I wanted to send it to him he was quite pleased and looked forward to reading it as he had little knowledge of TRT and its relationship with AIDS. When I had an appointment with him in November he told me how impressed he was with what I sent him. I was a little disappointed because he wasn't quite as excited as I hoped he'd be. But I let that feeling slide when he told me he was more than willing to work with me and was satisfied in my guiding the way though the processes. Before leaving I told him I knew that there were tests that would need to done in a few months and that I would get to him regarding their scheduling.


Okay, cocarr, having said all that I want to stop for a moment and give you a warning. I DO NOT want to see your relationship with your doctor backfire on you like mine did with me two days ago. Two weeks ago I sent the Doc a printout of a posting Nelson did on minimum tests that needed to be run and their frequency. For six months that included the following: CBC, Testosterone, Free & Total, PSA, LH & FSH, Lipids, CBC, CMP and Estridol (ultrasensitive). When the labs were scheduled his office let me know. When I went in for work to be done I was told the only test scheduled was Testosterone Free and Total. Without my prior knowledge PSA,CBC and CMP were scheduled for mid May along with my annual HIV test. No other tests had been scheduled. So two days ago I called the doctors office to ask what had happened and was told by his PA that the Doc no longer wanted to work with me on on TRT and that any consultation and scheduling of tests needed to be done with my PCP. So, my warning to you is that going into this with a doctor who is not trained in testosterone, even though you've educated the hell out of him, is not a sure thing. If the going gets tougher than he expected or he gets nervous about something he could suddenly drop you. I'm not saying this is going to happen to you but I want you to keep it in the back of your mind. Your Doc sounds like a nice guy who'd be willing to sit down and have a nice heart to heart with you. Explain how this is an extremely important lifelong commitment you're making and that you'll need his unending support. I'm a little concerned about your Doc's age. Ask him frankly if there's a doc he can refer you to if he suddenly needs to retire or dies.


Again, congrats! I'll be keeping my fingers crossed in hoping this relationship works out for you. In the meantime I hope other members on this site will keep their fingers crossed for me. I'm stunned by what's happened and don't understand what went wrong. I asked my Doc's PA if the Doc was upset with me and she said "Oh, absolutely not! I think he's just decided he's not comfortable dealing with testosterone." Wonderful. Thanks for tellin' me now, Doc!


Next week I'm calling my PCP and see if he'll help me with TRT. Dr. Joe is a wonderful man whom I have the utmost love and respect for. He's been my PCP for 24 years, is slightly younger than me, very respectful, ego free and soft spoken. Every time I see him I'm left with the feeling that I've just had a wonderful visit with the family priest. I've caught myself a few times almost addressing him as "Father Joe". I saw him late last spring with a respiratory problem just before I started TRT. I saw him again last month regarding a pulled quad muscle. When he walked in the door he stopped and said "You look fantastic! You're HUGE!" He continued with "I can tell your mood is better, you're not depressed and the sparkle is back in your eyes." He ended this visit with "I have a lot of guys ask me about testosterone and I'm always hesitant in recommending it. First, there's the lifelong commitment which most men don't realize and second is the cost. It's expensive and a lot guys don't have insurance that will cover it. In your case it's obviously done a lot of good and I'm absolutely thrilled that you're doing it!" I have to tell ya, when I walked out of his office I was floating on Cloud Nine! When I put the material together that I sent to my HIV Doc I made a second copy with the intention of sending it to Dr. Joe. I never sent it because it didn't excite the Doc as much as I hoped it would so I thought it might not excite Dr. Joe that much either. When I saw him I told I had a copy for him and he seemed thrilled and said he'd love to read it. I haven't sent it yet and want to update it a bit and play up EXCELMALE a bit. So what do you think guys? Think this Doc will help me out? I'm sure hoping so!
 

cocarr

New Member
I will for sure Gene. I feel like my kids do the weeks leading up to Christmas. I am really curious to see what the tests show and get your opinion on them.
 

cocarr

New Member
Rorinsmith that is a real bummer about your Dr. just dropping you like that. On a positive side maybe there was a reason. Old dumb saying but usually things do happen for a reason.

I was worried that a specialist may be to arrogant and stuck in their ways to essentially do things the way I wanted. That is where my PCP's lack of knowledge and lack of ego became a huge factor. I had a feeling that I could prove to him why I wanted things done a certain way and that he would go along with it. Dr. Crislers write up was a huge factor in that given that it laid everything out and didnt take him hours to read it. He is a busy guy and though he may have wanted to read a more detailed approach he likely would have passed just based on a time factor.

I am just confident that through this site, the knowledge I am gaining, and my Dr. being a smart man that things will go smoothly. He has been my PCP for quite a few years and the Dr. who delivered me when I was born and he are friends. That Dr. was my PCP for 30 years until I moved and had to switch to my current doc. Not saying it couldnt happen but I dont think he will bail on me. He may decide to refer me but I think he is as curious about the process as I am and I got the feeling that he genuinely wanted to learn whatever he can about it. I think he felt bad about how he had went about TRT up to this point and wants to do things right going forward.

Good luck to you friend and just keep your chin up. Likely you will move on with father Joe and look back at it as the best thing that could have happened. I know id rather have a Dr. who I can trust and confide in than the most knowledgable Dr in the world.
 
Thanks for all of the responses fellas and Dr. Crisler thank you for your "simple", to the point map. It in and of itself has given me some piece of mind in starting this process and I now know that things will be heading in the right direction.

Taking the first steps I think is the hardest. It was for me anyway. I felt like a dog chasing his tail and even after I found this site and started learning some things I still felt like I had no direction since I had yet to find a specialist. I would have even been more hard pressed to find a specialist who was open to my suggestions. That is where my PCP's open mindedness really saved me. It was a shot in the dark as to rather he would be stubborn or go along with it.

The best part is the information that I read and pass on to him is understood at a whole different level since he is a very smart man. Having been a Dr. since dinosaurs roamed the earth he has to be haa.

Also I went this morning and had my bloodwork drawn. My Dr. ordered everything exactly as Dr. Crisler suggested and even went so far as to find all of the lab numbers in his book so it would be done right. Rather than just order the "sensitive estradiol" he found the code for it so there are no mistakes. I will hopefully have the results back on Monday or Tuesday and I can post them up on the labs thread. Very curious to see where everything else falls.
Thank you for the idea! I will include the codes for the major labs in the paper. I hope that helps.
 

HarryCat

Member
cocarr, is your PCP in an independent practice or part of a large group. Back when I had a PCP with an independent practice I found that he was open to suggestions and other ideas, after he retired the only PCP I could find was part of a large hospital chain. There a no independent PCP's left in my area. My new PCP seems to be under a lot of stress and constantly has someone looking over her shoulder monitoring how many patients she treats, how many tests she orders, etc. Needless to say she is on a very short leash and can't think outside the very regimented protocols defined by her employer. So I ended up having to find someone else for my TRT.
 
cocarr, is your PCP in an independent practice or part of a large group. Back when I had a PCP with an independent practice I found that he was open to suggestions and other ideas, after he retired the only PCP I could find was part of a large hospital chain. There a no independent PCP's left in my area. My new PCP seems to be under a lot of stress and constantly has someone looking over her shoulder monitoring how many patients she treats, how many tests she orders, etc. Needless to say she is on a very short leash and can't think outside the very regimented protocols defined by her employer. So I ended up having to find someone else for my TRT.
HarryCat, it looks like the days of a PCP with an independent practice are long gone. And I think this has a lot to do with Medicare. I do know that Medicare has caused drastic changes with hospitals when new rules went into effect two years ago. Both of my Doc's are part of a large Catholic charities medical group that operates in five states. Huge changes in staff and staff reduction, consolidation and computer system changes have had a dramatic and unpleasant affect. The funny thing is that as much as these people try to mask their frustration and stress, all of us patients can see right through it and know that something's going on.
Ron
 

cocarr

New Member
cocarr, is your PCP in an independent practice or part of a large group. Back when I had a PCP with an independent practice I found that he was open to suggestions and other ideas, after he retired the only PCP I could find was part of a large hospital chain. There a no independent PCP's left in my area. My new PCP seems to be under a lot of stress and constantly has someone looking over her shoulder monitoring how many patients she treats, how many tests she orders, etc. Needless to say she is on a very short leash and can't think outside the very regimented protocols defined by her employer. So I ended up having to find someone else for my TRT.

Luckily he only answers to himself. He has had his practice for near 40 years. I do fear when he retires I will be hard pressed to find another Dr. who is as open minded as he is. I hope he can last awhile though and by that time hopefully my levels will be balanced out and I can find a Dr. who will agree to carry forward with the plan that is working.
 

cocarr

New Member
Well I got my lab work back and my Dr. did not order FSH or LH values. I am not sure how important they are for a baseline.

Value Range
Cholesterol, total 180 100-199
Trig 121: 0-149
HDL 40: >39
VLDL 24: 5-40
LDL 116: 0-99
Thyroxine (T4) free 1.19: O.82-1.77
Estradiol sensitive 9: 3-70
Testosterone free 7.9: 8.7-25.1
Triiodothyronine free 3.2: 2.0-4.4

My CBC and total thyroid were done in the last test and everything was within normal limits. I am somewhat disappointed that he did not order the LH and FSH though if my T (229) and free T (7.9) are both low I would assume that those values (LH, FSH) would be low as well. Maybe that is why he did not order them. I am also pretty disappointed in myself that my cholesterol values are bad. My HDL is barely above, LDL is on the high end and my triglycerides are on the high end. Time for some life changes for sure.

He prescribed me androgel 2.5 and will repeat labs in 6 weeks. Gene, guys what do you think.
 

Gene Devine

Super Moderator
Well I got my lab work back and my Dr. did not order FSH or LH values. I am not sure how important they are for a baseline.

Value Range
Cholesterol, total 180 100-199
Trig 121 0-149
HDL 40 >39
VLDL 24 5-40
LDL 116 0-99
Thyroxine (T4) free 1.19 O.82-1.77
Estrediol sensitive 9 3-70
Testosterone free 7.9 8.7-25.1
Triiodothyronine free 3.2 2.0-4.4

My CBC and total thyroid were done in the last test and everything was within normal limits. I am somewhat disappointed that he did not order the LH and FSH though if my T (229) and free T (7.9) are both low I would assume that those values (LH, FSH) would be low as well. Maybe that is why he did not order them.

He prescribed me androgel 2.5 and will repeat labs in 6 weeks. Gene, guys what do you think.


I would like to have seen Free/Bio Available Testosterone and SHBG along with LH/FSH. Usually LH/FSH are part of the Total Blood Chem so don't know why you didn't get it.

Your Estrogen levels are low and probably won't budge much with a transdermal. For that reason I may have asked for weekly injections.

On a transdermal you don't need to wait 6 weeks; two weeks is sufficient.

Did he prescribe HCG to keep your Testes alive now that you will be HPTA suppressed?
 

cocarr

New Member
Im not sure what you mean by "total blood chem". The did not order a BMP or CMP just the cholesterol. I'm not really sure why he didnt just order a BMP to kill two birds with one stone.

So by my Estradiol being a 9 you dont think the transdermal will work? I specifically asked for the transdermal based on Dr. Crisler's T paper. My Dr. was going to go with injections.

As to HCG he was not very keen on that. I am married with 3 kids and my wife has had a tubal so testicular function is not important to me. Even atrophy is not a concern of mine due to being married.
 
Buy Lab Tests Online

Sponsors

bodybuilder test discounted labs
Defy Medical TRT clinic
nelson vergel coaching for men
Discounted Labs
TRT in UK Balance my hormones
Testosterone books nelson vergel
Register on ExcelMale.com
Trimix HCG Offer Excelmale
Thumos USA men's mentoring and coaching
Testosterone TRT HRT Doctor Near Me
how to save your marriage

Online statistics

Members online
4
Guests online
7
Total visitors
11

Latest posts

Top