Meet with Dr. Tomorrow Please Help.

[CLewis]

I meet with my Dr. (A Mens's Clinic) tomorrow. I need help reading my blood work. First a little about me and why I went to the mens clinic.

41 Years old
5'6-7"
170lbs
I eat well (to much red meat)
exercise 5-6 days a week albeit all cardio

Three years ago I went to my family doctor wanting him to check my T levels. I was feeling tired, depressed, hard time concentrating and just total lack of energy. He did so and it came back at 362. There was not much information on the sheet he gave me back but can post later if needed. He said it was on the low side of normal but still normal and sent me on my way.

Fast forward to the last month. My concentration is horrible. I have been short tempered and irritable with my family and friends. Cant stay on track or concentrate. Strange memory issues like forgetting things. To me one of the hardest things to mange is no energy. Its effecting work and home life. I get home from work and fall asleep as soon as I hit the couch. I sleep 8-12 hours every night but always tired.

After reading this forum and reading Nelsons book I decided to skip my family doctor and went to a mens clinic last weeks. I'm pretty sure they would give TRT to anyone who walks into the door. They weighed me, took my heart rate, read over my questionnaire and then the doctor came in and told me that they would get my T levels up to 1000. A lady came in with a menu and told me to pick a package that they would give me a booster shot today, and once blood work came in the would set me up on weekly injections. knowing my t levels where 362 three years ago I went ahead and let them give me the 250 of Testosterone and a HCG shot (not sure how much). They also sent me home with DHEA.

I have a appt with my family doctor for a full physical. I wanted this before I went on a full TRT. The clinic sent me my blood work and my T levels show 430. It surprised me that they where higher after 3 years and it concerns me for some reason that is went up.

I know after reading post after post they say you can't tell any difference within a week of a shot but I have keep a diary every day this week that I would be more than happy to post if you would like. Anyways I was expecting no difference, but a few hours after the T and HCG shot my head got clearer and by the end of the night I still had energy. It can't be in my head as I have not been able to stay awake at the evenings for a very long time. Problem is I now can't sleep. I have only had 2 good nights of sleep since I started this last Wednesday.

I am sorry for this long post. I just feel like this doctor is more worried about getting my T level up to 1000 and that is it.

Please look over my blood work and give me some suggestions please. Test where done at 9:30am before he gave me the T and HCG shot.

 

[CLewis]

admin I'm sorry I should have posted this in blood test discussion if you would like to move it.

 

[CLewis]

Does anyone see anything strange about my blood work or any questions I should ask? With my T level being up to 430 should I even start TRT?

 

[CoastWatcher]

You have has an incomplete workup. Did I miss your SHBG level? PSA? Free testosterone? What was your LH and FSH prior to your starting therapy? Are you dealing with primary or secondary hypogonadism? You were given the wrong estradiol test. What are the details of your protocol? Two hundred fifty milligrams of testosterone...how often? You don't know how much HCG? Why not?

This is an unfolding disaster. You're a patient of a testosterone mill. You deserve better treatment.

 

[CLewis]

CoastWatcher I agree this could be a disaster which is why I have been researching as much as I can.

SHBG 39nmol/L
PSA .31 ng/ml
Total T 430ng/dl
Free T 7.19 ng/dl

The blood test was done before they gave me their "booster" shots (before any protocol). I am suppose to see them tomorrow to start a protocol. My paperwork for tomorrow say's up to 250mg a week. I find out how much HCG tomorrow as well. I know it seems stupid to let them give me HCG & T Shot without knowing how much they where giving me, but I trusted they knew what they where doing.

 

[CoastWatcher]

You really deserve better care than you are receiving, or will receive. It's a mill. We see it frequently.

A new patient comes in, is given a whopping big shot of testosterone, without an adequate workup, which will produce some effects, and then is signed up for a protocol. A protocol calling for far too much testosterone, guaranteed to send estradiol (which was measured with the incorrect test) skyrocketing. They are likely to put you on an AI hoping to counteract that e2 spike, but they will likely prescribe too large a dose so you may crash your estradiol...but they won't administer the proper test so you won't know that. Of course, you will have to travel to them for injections, they will charge for that as well. It's just short of criminal.

Please consider finding better care. We can offer you national practices that are affordable if local doctors aren't available.

 

[CLewis]

Thank you CoastWatcher! I have been reading about Defy. I wish I would have know sooner. I need to decide what to do from here. They did sell everything in packages. I went with the 6 month package and already paid. Yes you can roll your eyes at me I'm a big boy. They are a local company only 15 min away from me with a couple of location and great reviews. So I thought all was good until really diving deep into this site. I can go into the office for shots but they let me do it at home as well.

At this point not sure what I should do seeing that I have paid. After seeing my blood work do you think a TRT will help with my issues? That is the most important part really. If so since I will be self administrating the HCG and T myself should I try my own protocol? Use the them for the six month and move on with a place like Defy?

After reading over this. It sounds crazy that I let this situation happen but it did...

 

[CoastWatcher]

You aren't the first to fall down the rabbit hole and, sadly, you aren't going to be the last. Inadequate medical care in this particular field is far too common.

I do think you are a man who could benefit from a well managed TRT protocol. If it were me, I'd avoid this practice. Rely on them for six months...to do what? Mismanage your hormonal health? And then turn to a practice like Defy to go in and sort out the mess? No, I'd look at it as a painful lesson learned.

The money you paid is gone. Don't compound the error by allowing these people to send your health to a deeper level of misery. Call Defy tomorrow and start the process for your initial consultation. You have many of the labs you need, you won't have to duplicate those efforts or costs. I'm not a Defy patient, I live in Canada, but I have great respect for their model.

I simply would not permit those vultures anywhere near me.

 

[LTChris]

After reading over this. It sounds crazy that I let this situation happen but it did...

it is not crazy. I made a similar mistake. Fortunately you found this site and realize your situation a lot quicker than I did. Best of luck

 

[1Draw]

I was with another T clinic before finding this site and Defy. Took me 9 months to finally get started with them and have been very very pleased with service and medical advice. From your blood work, your free T is low at 7.9 and your VitD is on the lower end. The suggested 250mg of Testosterone a week is going to be a train wreck for you IMO.

Other experts will have ideas but if it were me, I would start out with the following:
TCyp - .5 ML 100 mg/Week
HCG - 250 IU's EOD - SQ
VD3 - 5,000 IU's Daily
DHEA - 25 MG Day

Get blood work done after 6 weeks to see what your levels are. Have blood drawn on day of shot before the shot to get a good trough. The regular estradiol testing is what my old clinic used and never could convince them to test Sensitive. They didn't even test for Free T....Duh!

You can always adjust up or down depending on your 6 week labs. I would also add a CBC panel on your next blood work to keep an eye on your Hematocrit. You don't want it to spike too high. Good luck to you and keep us updated on your progress!

 

[Vince Carter]

362 and 430 are close enough to be statistically null and I wouldn't make any conclusions about it.

Further guys feel a certain euphoric(?) state when starting HRT because they're in a spot for 3-4 weeks where they have endo as well as exo T in their system but this feeling wains as HPTA shutdown occurs and endo T stops and the exo T becomes the only T...sounds confusing but is the cause that people say the first weeks are amazing. Trick is is getting past the shutdown and negative feedback and getting your T up and your E2 monitored and if necessary, controlled.

Strange a clinic wants to hit you with 250/week, that's too much.

 

[Vince Carter]

CoastWatcher I agree this could be a disaster which is why I have been researching as much as I can.

SHBG 39nmol/L
PSA .31 ng/ml
Total T 430ng/dl
Free T 7.19 ng/dl

The blood test was done before they gave me their "booster" shots (before any protocol). I am suppose to see them tomorrow to start a protocol. My paperwork for tomorrow say's up to 250mg a week. I find out how much HCG tomorrow as well. I know it seems stupid to let them give me HCG & T Shot without knowing how much they where giving me, but I trusted they knew what they where doing.

LowTCenter was like that for me, very secretive and I started asking more questions as I gained information, they weren't shooting me with 100-105mg/week and no HCG but it took some work and questioning on my part to figure out how they were treating me which it really shouldn't be that way.

 

[CLewis]

Thank all of you for the information! I will be calling Defy today. I keep my appt to see what they would say after the blood work. I found out they gave me 400mg of T and 200mg of HCG as their booster last week . That could be the reason that I have not been able to sleep!? They where going to put me on a protocol of 300mg of T, and 200mg of HCG a week. Alog with 100 of DHEA a day

Thanks again for pointing me in the right direction!

 

[CoastWatcher]

Thank all of you for the information! I will be calling Defy today. I keep my appt to see what they would say after the blood work. I found out they gave me 400mg of T and 200mg of HCG as their booster last week . That could be the reason that I have not been able to sleep!? They where going to put me on a protocol of 300mg of T, and 200mg of HCG a week. Alog with 100 of DHEA a day

Thanks again for pointing me in the right direction!

Far too much testosterone. It would almost certainly send your e2 into orbit. At the same time, that's a modest HCG dose. None of what they proposed makes any sense.

You are making the right decision to go with Defy. Keep us post D.

 

[Dr Justin Saya MD]

They gave a 400mg T cyp injection as a "booster" and then want to prescribe 300mg of T cyp per week as a maintenance dose...they are clueless and you are fortunate to have seen the writing on the wall sooner rather than later!

 

[CLewis]

Defy ordered some additional blood work for my consultation. My LH came in at .2 (1.7-8.6) and Estradiol, Sensitive was 58.9 (8.0-35.0) those seems super low and crazy high. I need to read up a bit more on LH I don't really know what that is yet.

 

[CoastWatcher]

Defy ordered some additional blood work for my consultation. My LH came in at .2 (1.7-8.6) and Estradiol, Sensitive was 58.9 (8.0-35.0) those seems super low and crazy high. I need to read up a bit more on LH I don't really know what that is yet.

Yiur LH is likely reduced because your exogenous testosterone injections have suppressed it. That's typical. It's frustrating your initial doctor didn't order it prior to the start of therapy. Your e2 is up because your prescribed dose likely sent it skyrocketing.

 

[CLewis]

Gotcha thanks!

 

[CoastWatcher]

Gotcha thanks!

Defy will help you sort out your situation. However, it really is in your best interest to read the sticky posts here at Excelmale and become comfortable with the elements of TRT. All of us, now matter how capable our doctors are, must become our own advocates.

Keep us posted as things unfold.