Frustrated - Need advice finding a doctor

[Antisosa]

Hello, try to break down my situation shortly.

Started TRT 9 weeks under my urologist. I've found the doctor I'm seeing doesn't know much about TRT. Didn't test me for anything but total T. I needed to request all the correct tests 8 weeks in (FreeT, E2, SHBG) because he had no idea it was necessary.

After my last appointment, I asked for a full Thyroid panel to be done because my E2 sensitive was @ 18 pg/ml. and my total test @ 1100. Dr told me he is not comfortable doing this because he wouldn't know how to read it and I need to see an Endo. In fact he didnt even want to order my E2 blood test but did it anyways.

So now I need to change Dr's. After searching for a male endo in my area, no one is taking new patients. And the one that I found was not available until October 17th. I have very good insurance and I would like to go thru them if possible. I understand I can go to Defy or other places but it can be costly. What can I do?



About me:

30 years old 5’3 142 lbs (10%BF)
I went into the Dr because of the same TRT symptomsas most.. such as fatigue, no sex drive, no motivation..brain fog all the time
Taking 50mg testosterone e3.5d

 

[Vince Carter]

Knowing you're location would be helpful here. But if it were me and you're doing OK with this Dr/Uro/Endo to the point that they just need a little guidance, and they're open to it, it may be best to stay, if they're going to keep you on Testosterone. You can get the labs thru discounted labs but that's OOP and I fully understand the insurance aspect of it all, but, TRT really isn't an insurance kind of thing outside of what youre getting from your GP/Uro/Endo.
The only place I know of that (was) taking and filing insurance was LowTCenter but they're treatment plans are horridly antiquated and incomplete. (personal exp).

 

[Antisosa]

I'm from zip code 60062 which is right outside Chicago.

I literally brought it all the tests I would like, with the lab numbers (I called the hospital before hand to get them). And he wouldn't do it.. He said that he wouldn't know how to read them and I need to go see an endo. Seemed like he was getting more and more uncomfortable with the TRT as I kept asking questions and asking for other tests. I also asked him if he knew what hcg was, and he said he knows but not familiar with it.

However, if I do get them thru discountedlabs, that's mostly just for my personal being right? I wouldn't be able to bring them to the Dr and say I got outside tests done and need treatment?

 

[madman]

Hello, try to break down my situation shortly.

Started TRT 9 weeks under my urologist. I've found the doctor I'm seeing doesn't know much about TRT. Didn't test me for anything but total T. I needed to request all the correct tests 8 weeks in (FreeT, E2, SHBG) because he had no idea it was necessary.

After my last appointment, I asked for a full Thyroid panel to be done because my E2 sensitive was @ 18 pg/ml. and my total test @ 1100. Dr told me he is not comfortable doing this because he wouldn't know how to read it and I need to see an Endo. In fact he didnt even want to order my E2 blood test but did it anyways.

So now I need to change Dr's. After searching for a male endo in my area, no one is taking new patients. And the one that I found was not available until October 17th. I have very good insurance and I would like to go thru them if possible. I understand I can go to Defy or other places but it can be costly. What can I do?



About me:

30 years old 5'3 142 lbs (10%BF)
I went into the Dr because of the same TRT symptomsas most.. such as fatigue, no sex drive, no motivation..brain fog all the time
Taking 50mg testosterone e3.5d

Your e2 sensitive is really low for a total t of 1100 are you on an aromatase inhibitor, how do you feel overall?

 

[Antisosa]

I am not on an aromatase inhibitor nor is it compounded into my testosterone. I feel Decent but there are days where I feel real weak and fatigued . That's kind of why I wanted to get a thryoid panel done.

 

[Vince Carter]

Right the tests you would buy are for your own use, Dr might reference them but if he's already reluctant then its kind of pointless. We can analyze results much better than most Dr's but we can't get you meds haha

 

[Antisosa]

I just sent me general doctor a message to see if he will he will put the tests in for me. I swear I'm so frustrated with this around and around. Plus I wanted hcG to restore fertility and now Indont know how that's possible since I have to wait till October to get with this endo

 

[Vince Carter]

You've got the same frustrations that drive a lot of us to the telemed delivery models.

 

[Antisosa]

Trust me. I'm not far away. Sad we need to be our own Doctors

 

[Will Brink]

Hello, try to break down my situation shortly.

Started TRT 9 weeks under my urologist. I've found the doctor I'm seeing doesn't know much about TRT. Didn't test me for anything but total T. I needed to request all the correct tests 8 weeks in (FreeT, E2, SHBG) because he had no idea it was necessary.

After my last appointment, I asked for a full Thyroid panel to be done because my E2 sensitive was @ 18 pg/ml. and my total test @ 1100. Dr told me he is not comfortable doing this because he wouldn't know how to read it and I need to see an Endo. In fact he didnt even want to order my E2 blood test but did it anyways.

So now I need to change Dr's. After searching for a male endo in my area, no one is taking new patients. And the one that I found was not available until October 17th. I have very good insurance and I would like to go thru them if possible. I understand I can go to Defy or other places but it can be costly. What can I do?



About me:

30 years old 5’3 142 lbs (10%BF)
I went into the Dr because of the same TRT symptomsas most.. such as fatigue, no sex drive, no motivation..brain fog all the time
Taking 50mg testosterone e3.5d

By in large, you will continue to be disappointing if trying to get insurance to cover it all as much of what a good doc might do, tests run, etc, not covered. It's a damn shame, but getting an extensive blood panel done, anything but basic TRT (and some don't cover that....) is difficult to impossible depending on the insurance and other factors. Thyroid at least will be covered as a rule. Good news is, blood work has gotten reasonable through places offered here, like Discount Labs, Life Extension, etc. and some meds you may need can be purchased over seas etc, or you may simply want to go with Defy or others as a good doc that's knows what they are doing vs fighting with idiots and insurance companies just not worth the stress and $ saved in my experience.

- Will @ www.BrinkZone.com

 

[Antisosa]

Right now my Main goal is to understand why e2 level is at 18 with test @ 1100. Hoping thyroid will help see why as my other results came back fine. And other goal is hcg. I would think that's pretty normal stuff covered and prescribed. But the hcg may have to be bought overseas since I cannot get to a doctor till October! Thoughts?

 

[FabFred]

Defy is not expensive once you get past the initial consultation and bloods. Also, the Doctors and PAs there are top notch.

 

[CoastWatcher]

Right now my Main goal is to understand why e2 level is at 18 with test @ 1100. Hoping thyroid will help see why as my other results came back fine. And other goal is hcg. I would think that's pretty normal stuff covered and prescribed. But the hcg may have to be bought overseas since I cannot get to a doctor till October! Thoughts?

Defy offers a on HCG support program for patients who are unable to obtain it through their treating physician.

 

[CoastWatcher]

The sad fact of the matter is that very few endocrinologists understand contemporary androgen management in men. I initially consulted a man who holds an endowed chair at a local medical school, in endocrinology, and it was a total waste of time. Honest endocrine specialists will tell you they had very little training in this area. The doctors at the cutting edge of this field are in urology or family practice - a hard truth. Most of these physicians have grown so frustrated with insurance company impediments that they have adopted fee for service models. Another hard truth.

I wish you the best as you continue to search for an in-network provider. You pay for your insurance coverage...it would be nice to be able to use it. But think of your automobile. How many substandard mechanics would you consult before taking it to someone who could actually do what needed to be done...even if it had to be carefully budgeted for.

 

[Antisosa]

I'm not sure what to do.. because I've already had these tested and I dont know if I'd have to re-take the tests and pay again if I went to another place, such as Defy (added ranges in because it was easier to copy and paste)

Date	Test	Value	Standard Range
7/20	TESTOSTERONE, TOTAL	1012.0 ng/dL	249.0 - 836.0 ng/dL
7/20	PSA DIAGNOSTIC (ROCHE)	0.64 ng/mL	0.00 - 2.00 ng/mL
7/20	ESTRADIOL	8 pg/mL	27.1 - 52.2 pg/mL
7/20	TESTOSTERONE, FREE	31.8 ng/dL	4.85-19.0 ng/dL
7/20	SHBG	30 nmol/L	10-57 nmol/L
7/21	ESTRADIOL (ICMA) Sensitive (e2)	18 pg/mL	8-35 pg/mL

4/20 TSH REFLUX 0.828 u[IU]/mL 0.300 - 5.600 u[IU]/mL

[TD="class: cms_table_valueCol"]0.828 u[IU]/mL [/TD]

The sad fact of the matter is that very few endocrinologists understand contemporary androgen management in men. I initially consulted a man who holds an endowed chair at a local medical school, in endocrinology, and it was a total waste of time. Honest endocrine specialists will tell you they had very little training in this area. The doctors at the cutting edge of this field are in urology or family practice - a hard truth. Most of these physicians have grown so frustrated with insurance company impediments that they have adopted fee for service models. Another hard truth.

I wish you the best as you continue to search for an in-network provider. You pay for your insurance coverage...it would be nice to be able to use it. But think of your automobile. How many substandard mechanics would you consult before taking it to someone who could actually do what needed to be done...even if it had to be carefully budgeted for.

 

[johndoesmith]

I'm not sure what to do.. because I've already had these tested and I dont know if I'd have to re-take the tests and pay again if I went to another place, such as Defy (added ranges in because it was easier to copy and paste)

Date	Test	Value	Standard Range
7/20	TESTOSTERONE, TOTAL	1012.0 ng/dL	249.0 - 836.0 ng/dL
7/20	PSA DIAGNOSTIC (ROCHE)	0.64 ng/mL	0.00 - 2.00 ng/mL
7/20	ESTRADIOL	8 pg/mL	27.1 - 52.2 pg/mL
7/20	TESTOSTERONE, FREE	31.8 ng/dL	4.85-19.0 ng/dL
7/20	SHBG	30 nmol/L	10-57 nmol/L
7/21	ESTRADIOL (ICMA) Sensitive (e2)	18 pg/mL	8-35 pg/mL

4/20 TSH REFLUX 0.828 u[IU]/mL 0.300 - 5.600 u[IU]/mL

[TD="class: cms_table_valueCol"]0.828 u[IU]/mL[/TD]

If your labs are recent, there's no need to reorder the ones you already have. I believe it's under 2 months for them to accept.