Beginning a new TRT chapter

[seaexplorer]

Hello all,

Another new guy here that has stumbled onto this magnificent forum.

I've been on TRT treatment for over 10 years and the whole experience has been utterly disappointing in every way possible. I've really reached a breaking point and need to try a new treatment and that's how I found this site.

Here is a summary of my "Disaster Decade of TRT" which will explain why I'm fed up and looking for a change.

When I got the classic symptoms of Andropause at around age of 40, I had to practically beg my Dr to test my levels. He only tested Total-T and that came back at around 300 and he said it's normal. No further discussion was available.

I then went to an "anti aging Dr." who proceeded to "prescribe" me all kinds of expensive supplements, and like an idiot, I paid $400 a month and after a year, my T was still the same.

I then looked for another "hormone specialist" Dr by reading through a directory of "Innovative Drs" provided by Life Extension magazine, and when I did basic license checks with the state medical board, the majority of the Drs had pretty severe disciplinary action against them and appeared to become "anti aging / hormone" Drs in an effort to recover their livelihood. I passed on those.

Next I found a Dr that seemed great. He prescribed me some type of "plant based" testosterone precursor cream to apply to the bottom of my feet and behind knees. I did that for a year and my T dropped further and my symptoms worse. I'll cry if I type out how much I spent for this.

The next Dr also seemed great, had good reviews, and he gave me my first TRT prescription which was a "bioidentical T" cream made by a compounding pharmacy. (I believe my dose was 5g) This was very expensive and I started thinking that good treatment might only be for the rich and famous. I reached a point where I just couldn't afford it anymore, so I crawled to my PCP and practically begged for help.

He tested me, just total T and Thyroid, and put me on 5g of Androgel. The first month I felt like I was 18. It was great, then after it was ok for a couple years then my symptoms got worse. A retest showed that my total T was under 300 so he doubled my dose.

After a couple years of Androgel, my insurance started giving me a hard time. I got put on a generic equivalent and for the past year I have experienced classic low T symptoms and follow up testing shows a range of 500 to 600 each time and my Dr claimed his treatment was a success. I ask my Dr if I should have Estradial tested, or free T tested, and he practically gets offended that I'm questioning this. I'm not trying to tell him how to be a Dr., I honestly don't know, and it seemed common sense that more than just total T should be tested.

I'm sick and tired of applying gel. I have to wait before going in water or have contact with my wife, plus I don't think it's really working well. I did ask my Dr if injections might be better and he said we could try but it would be a once month injection. I'm sorry, I'm not an MD but even I know that isn't good. So frustrating ...

Finally when I went to pick up my generic androgel refill last month, the pharmacy clerk rings it up and says "that will be $450" ... it was my health insurance doing it's thing and that was what made me snap and decide enough: there has to be a better way to get treatment without having to see a movie star Dr. (while I search for a new treatment protocol, I'm getting getting a generic gel on my own in Mexico called LowTiyel and I think it's placebo batch)

Reading here has been an eye opener and it's inspiring to read others experiences. I dumped my TRT treatment from my PCP and will find a new option which will hopefully end my "Disaster Decade of TRT".

I'm not a MD nor try to be one or self diagnose, but there has to be at least someone in the US that can offer good treatment without the celebrity costs.

My mission now is to find a pro Dr with this stuff and I will be his or her best patient and this partnership will result in actual health and lifestyle benefits. If I have to do telemedicine or take injections, I don't care. I must find someone who can help and I think this wonderful site of excelmale will be a great resource in my search.

 

[CoastWatcher]

Welcome to Excelmale. Your experiences are beyond belief...I'm sorry you had to endure that. There are two national practices that are sponsors of this site, Defy Medical and Prime Body. I am a patient of neither, but in good conscience can suggest you contact both of them and explore your options.

I know now more about Defy, and their medical director, Dr. Justin Saya. He is one of the leading physicians practicing in this field today, a moderator here at EM, and a good fellow. Type his last name, Saya, in the search box here on the Forum and browse some of his posts to get a sense of his contributions. Then call Defy and ask them as many blunt questions as you can. They won't dodge. Lots of our members are satisfied, very satisfied, with their treatment.

Prime Body operates with a different model, but also serves many of our members. They offer a network of physicians - you should contact them as well.

You aren't the first member who came here after being disappointed with the care they have received. TRT is not a blind alley for most men once they find the right doctor. We're glad you're here and hope you'll be an active member.

 

[Vince Carter]

Welcome to Excelmale. Your experiences are beyond belief...I'm sorry you had to endure that. There are two national practices that are sponsors of this site, Defy Medical and Prime Body. I am a patient of neither, but in good conscience can suggest you contact both of them and explore your options.

I know now more about Defy, and their medical director, Dr. Justin Saya. He is one of the leading physicians practicing in this field today, a moderator here at EM, and a good fellow. Type his last name, Saya, in the search box here on the Forum and browse some of his posts to get a sense of his contributions. Then call Defy and ask them as many blunt questions as you can. They won't dodge. Lots of our members are satisfied, very satisfied, with their treatment.

Prime Body operates with a different model, but also serves many of our members. They offer a network of physicians - you should contact them as well.

You aren't the first member who came here after being disappointed with the care they have received. TRT is not a blind alley for most men once they find the right doctor. We're glad you're here and hope you'll be an active member.

All of this...great post CW

 

[FeelingLost]

Welcome seaexplorer,
"anti aging Dr." Do you even need a degree in medician to be one of them?

Best of luck on your journey to a better TRT protocal.
The EM members here have been very welcoming, tolerant and helpful to me.

 

[Dr Justin Saya MD]

I am humbled by your praise, Coastwatcher and Vince alike. Our mission is to help as many patients, just like seaexplorer, as possible to have access to quality and affordable hormone/wellness care. It is very disheartening to hear reports of experiences such as that of seaexplorer, but at the same time strengthens our resolve to continue in our mission as there is much work to still be done.

Best of luck to you, seaexplorer, as you continue your journey. Don't give up after you've come this far!

 

[seaexplorer]

Thank you everyone for the responses. I appreciate you taking the time to respond to a new person here.

Ive been reading a lot here.

Sorry, but just feel like ranting a bit ...
prior to finding this site, I've been calling around various clinics that have a specialization in TRT and that has been a very hopeless exercise. Yes, I did find some experts, but they were all extremely expensive, cash only, and no insurance. I also visited a couple clinics in my area, one having a well known Dr that seems amazing, but the $500 office visits are too expensive for me. And what's with these Drs turning into supplement salesmen? I hear the same pitch over and over that they only offer "pharmaceutical grade supplements that can only be provided by physicians", then they push supplements with really high markup. I know, and appreciate everyone needs to make a living, but anyone can find these so-called pharmaceutical grade supplements, same exact brands sold by the Drs, online and pay much less. When I talk to a prospective new Dr and they begin a supplement sales pitch, I walk out right there or hang up the phone. I'm not a rude person, but I've really have had it with this. It's actually kind of insulting getting a supplement sales pitch and being expected to pay double the price that can be found online.

I have an official diagnosis of low T, and have health insurance, and now I clearly see how the insurance dictates the care -- it's generic androgel or a monthly injection, and that's it -- as long as your total T is above 300, it's considered a success. it's clear that I'm going to have to "own my treatment" and go outside my insurance and this too is quite frustrating.

I've already accepted that I'm going to have to pay for this on my own and forget about my insurance, but hopefully I can find a place that will at least let me use my insurance for labs. I'm totally fine paying a fair fee for a Drs time. I would think that up to $250 per hour is reasonable, not $500 and not a need for monthly visits. I would also think that if non patented medications are prescribed, I should be charged a fair price, not some crazy $300 per month.

i will call some of the treatment centers mentioned here. I am actually feeling pretty optimistic now. I just want to end this decade of TRT disappointment and start new and get the benefits like so many here are enjoying. It's inspiring to read of others positive experiences and I'm determined to get to that point also.

thank you again to all who responded and welcomed me

 

[Sean Mosher]

Welcome!!
Sorry to hear your story but by talking with many guys here your story is far too common sadly.
As CoastWatcher mentioned, I'd be more than happy to answer any questions you may have about PrimeBody (site sponsor).
Feel free to PM me.

You will get great advice on this site for sure!

 

[ERO]

You can get fantastic care for less than $300/month. I use and recommend Defy Medical, as do many folks here, and they have no monthly fees at all. You just pay for Dr consults and meds. Also if you have recent blood work (I think it is within the last 30 days - I could be wrong) you can use that and not have to pay extra to get new blood work when you get started.

 

[seaexplorer]

Just a quick update: I have begun the process of trying to become a patient of one of the recommended Drs here. Now basically just waiting for Labcorp to get lab results so I can get a first consult scheduled. Nervous and excited but it looks like there's still a few weeks to go before having a plan in place.

 

[Readion]

Good luck! And keep us updated.

 

[seaexplorer]

After calling many places, I finally finished the process of selecting a new TRT treatment provider and decided to go with Defy. I really gave it a good shot to find a Dr in my local area, but they were all so heavy into pushing supplements and they were all way too expensive outside my league as they seem to target the rich and famous. Anyway, it took awhile to get setup and have my first consult because I spent a weeks talking with different places. I had my first consult and I finally feel like I'm in good hands now. During the consult, it was great to be able to discuss things that my primary care Dr basically forbid talking about such as HCG, testing and managing estrogen, etc.

Only one minor hassle with getting setup was with getting the basic physical done. My primary care Dr basically refused and says he's totally against what I'm doing, so I tried going to a few urgent care and minuteclinic type of places but kept getting tossed out when they saw the Defy form and the word "hormone". It was very strange that these places refused to do a simple physical and saying they have a policy of doing nothing involving hormones. Finally, I just left the Defy form at home and went to get a standard employment physical and that took care of that.

Defy gave me the choice of continuing with the gels or try something else. I went with their recommendations to go with the injections.

Today was my first injection day. I admit to being a big baby with needles but I was determined to overcome that. I watched the videos, read everything, and first did the HCG injection. I was a bit nervous about jabbing my abdominal area with a needle, but what helped was seeing the videos and nobody passing out or screaming in pain. Once the needle was in my hand and I had a pinch of skin ready to jab, it was almost like jumping off a high cliff -- that's how nervous I was, then I just said to myself "quit being a sissy" and jabbed it in and got it over with. It turns out it wasn't a big deal at all and I'm going to be ok moving forward.

For the testosterone injection, I gave my wife the honor of doing that one, right in the upper outer quadrant butt cheek, and that too was no big deal.

So now it begins, a new chapter. It felt nice not having to put the cream on. Keeping my fingers crossed this works. Next follow up is in 3 months.

 

[CoastWatcher]

After calling many places, I finally finished the process of selecting a new TRT treatment provider and decided to go with Defy. I really gave it a good shot to find a Dr in my local area, but they were all so heavy into pushing supplements and they were all way too expensive outside my league as they seem to target the rich and famous. Anyway, it took awhile to get setup and have my first consult because I spent a weeks talking with different places. I had my first consult and I finally feel like I'm in good hands now. During the consult, it was great to be able to discuss things that my primary care Dr basically forbid talking about such as HCG, testing and managing estrogen, etc.

Only one minor hassle with getting setup was with getting the basic physical done. My primary care Dr basically refused and says he's totally against what I'm doing, so I tried going to a few urgent care and minuteclinic type of places but kept getting tossed out when they saw the Defy form and the word "hormone". It was very strange that these places refused to do a simple physical and saying they have a policy of doing nothing involving hormones. Finally, I just left the Defy form at home and went to get a standard employment physical and that took care of that.

Defy gave me the choice of continuing with the gels or try something else. I went with their recommendations to go with the injections.

Today was my first injection day. I admit to being a big baby with needles but I was determined to overcome that. I watched the videos, read everything, and first did the HCG injection. I was a bit nervous about jabbing my abdominal area with a needle, but what helped was seeing the videos and nobody passing out or screaming in pain. Once the needle was in my hand and I had a pinch of skin ready to jab, it was almost like jumping off a high cliff -- that's how nervous I was, then I just said to myself "quit being a sissy" and jabbed it in and got it over with. It turns out it wasn't a big deal at all and I'm going to be ok moving forward.

For the testosterone injection, I gave my wife the honor of doing that one, right in the upper outer quadrant butt cheek, and that too was no big deal.

So now it begins, a new chapter. It felt nice not having to put the cream on. Keeping my fingers crossed this works. Next follow up is in 3 months.

Thanks for taking the time to update us. I believe your care, provided by the team at Defy, will be well managed. Good luck...and let us know how things play out.

 

[johnt]

"For the testosterone injection, I gave my wife the honor of doing that one, right in the upper outer quadrant butt cheek, and that too was no big deal."

@Seaexplorer What gauge needle are you using and length?

 

[seaexplorer]

It's a 25 gauge 5/8" length.

It really was no big deal. Eventually I would like to also be able to inject this one myself, but one step at a time. My wife has no problem jabbing a needle in me. I don't know why I'm such a baby about injecting myself although I did do the HCG shot myself totally fine. I never had any issues receiving shots but as far as giving to myself, I'm just going to have to overcome it.

 

[seaexplorer]

I just completed my second week of my new protocol prescribed by Defy and so far so good. The injections are no problem. I inject myself for the HCG and my wife injects the testosterone in my butt cheeks for me. I'd like to say it's because I have a nice rear that women can't resist, but the truth is I'm still a bit nervous to self inject in the glute for the time being. I'm also taking a very low dose AI and some previous itching that I was having in my pecs has gone away -- maybe it's from the AI, who knows, but I'm glad that has went away.

The main noticeable change I feel, and it's hard to describe, is it feels good to use my muscles. Doing once dreaded chores like lugging a 3 gallon water bottle up several flights of stairs actually feels good. I feel like my muscles are wanting to be used. Before, while on the cream, I never felt like that. It's a welcome feeling and now I'm planning to start introducing an exercise routine.

 

[CoastWatcher]

I just completed my second week of my new protocol prescribed by Defy and so far so good. The injections are no problem. I inject myself for the HCG and my wife injects the testosterone in my butt cheeks for me. I'd like to say it's because I have a nice rear that women can't resist, but the truth is I'm still a bit nervous to self inject in the glute for the time being. I'm also taking a very low dose AI and some previous itching that I was having in my pecs has gone away -- maybe it's from the AI, who knows, but I'm glad that has went away.

The main noticeable change I feel, and it's hard to describe, is it feels good to use my muscles. Doing once dreaded chores like lugging a 3 gallon water bottle up several flights of stairs actually feels good. I feel like my muscles are wanting to be used. Before, while on the cream, I never felt like that. It's a welcome feeling and now I'm planning to start introducing an exercise routine.

We contnue to wish you the best. Any difference in how you're sleeping, or was sleep not one of your challenges? It was a big one for me and it resolved quickly.

 

[seaexplorer]

We contnue to wish you the best. Any difference in how you're sleeping, or was sleep not one of your challenges? It was a big one for me and it resolved quickly.

Sleep is ok, unchanged. I did have problems in the past but when I started taking 5-HTP, Melatonin, and occasional Valarian root, I fall asleep pretty fast and sleep soundly. Not getting enough sleep is awful.

 

[Julian]

I was the same way when I started my injection protocol. my Dr. wanted me to use a 21G 1 1/2 inch I said hell no! so for the 1st 3 months I was using 25G 5/8" on my shoulder. My Dr. said that 5/8 wasn't long enough on the shoulder that I should use 1", which I never did. I use 25G 1" on my leg, I don't know if 25G 5/8 long is long enough for the area you are using.

 

[seaexplorer]

Quick update, I just had my first follow up and it seems I may be one of the lucky ones and possibly got dialed in on the first attempt:

My prescribed protocol is 140g Testsoterone as 70g every 3.5 days; 400iu of HCG every 3.5 days, and 0.125mg of Arimidix also every 3.5 days; DHEA 25mg daily

Total Testosterone, measured at trough, is 865 ng/dL reference range [348-1197]
Free Testosterone 30.7 pg/mL reference range [7.2-24]
SHBG 26 reference range [19.3-76.4]
DHEA-S 499 ug/dL reference range [71.6-375.4]
Estradiol, Sensistive 34.1 pg/mL reference range [8.0-35.0]

Overall feeling good. Libido has risen from the dead. Dr is going to keep things as-is and retest in 3 months. New tests to be done next will be DHT and IGF.

For the first time, I feel like I am receiving excellent care. I have to give credit to Excelmale in helping achieve this.

 

[1oldsoul]

Great to hear Seaexplorer. I just start a very similar protocol from Defy except for EOD instead of every 3.5. Spent my 44th birthday giving myself my first injection this past Monday. I wish you continued success!