New member in NC

[Mrfrieze]

Hey everyone, really awesome forum here. Lots of great information. I'll start out with a little background info. I am 39 years old, I work as a Auto Technician and live in NC. I have been having symptoms for a really long time. I would say they started by the time I was 20.

I have had problems with confidence, depression, anxiety, low libido, inability to build muscle, even when training very hard. I have tried every supplement there is. I have tried self medication throughout the years to relieve my symptoms.

For the last year or so I began wondering if these issues came from low testosterone. I kept hearing an ad on my local radio station for a low t clinic and decided to pay them a visit. They proceeded to validate my assumption with there lab test. They came back and told me that my TT was 232. My available Test was 3.9. Not sure how that is measured. I did not get my lab results they basically just explained how low I was and felt I would benefit fro therapy.

My first injection was 200 mg of Test Cyp on Thursday August 10th.
Week 2 was started on Wednesday the following week as I am trying to get to Monday for my shot. They then lowered the dose to 140 mg.
Week 3 was 140 mg on the following Tues
I go in for my 4th injection in the morning.
At 6 weeks, I will have follow up labs and a more permanent dose recommended, based on the changes I have made.

I have experienced an increase in libido and feel at random times I have an elevation in mood, however it comes and goes. I also seem to be slightly emotional on day 5 or 6 as well as slightly introverted.

I am excited to see how the treatment works for me and look forward to learning from this board.

 

[ERO]

Injecting only once a week is an outdated protocol for most guys, as is having to drive to the clinic for injections. 99% of us self-inject. Can you post your complete lab work? Sensitive E2, SHBG, thyroid, etc...Hopefully the doc checked all of those and not just Total and free T. If he did not, those are major red flags.

Adjusting your T dose absent of labs, making you drive in for shots, only dosing one shot a week - all of those are red flags that you need a better TRT doctor. Not trying to be a smart-ass, just being honest.

 

[Country23030]

Mrfrieze, welcome aboard! Lots of great info here but you won't find any love for the T-Mills even though thats were a lot of us get started. I myself have been on HRT about 3 months. My T-Mill has not run comprehensive labs to this point. One thing I will say is in the beginning I did experience what I have seen called on this site " the t-flu" I thought is was high e2 but they did test that and it was very low at 5<. and I had been taking an AI. My total t was also still low at 340. My original total t was 217 on my initial visit. I was started out on 200 mg. test c every two weeks. That didn't seem to set with me well so I asked to go to weekly and dose was changed to 160 mg. weekly. After about 3 weeks of that I felt good about 20 percent of the time. Thats when they retested the total t and E2 standard. I don't want to say what they increased my dose to now most members on this board would flip out. I'm just trying to feel better and learn more so I can move to a self administered program. I have a feeling daily injections will ultimately work best for me.

 

[Felinemedi]

I am glad everyone is enjoying the forum.

 

[Mrfrieze]

Hey thanks for the insight. The clinic I am going to did a complete panel. However they just went over the results they were concerned about I guess. They said my potassium was slightly high and retested it. Came back and said it was now within range may have been dehydrated. Mentioned taking a baby asprin. Said my PSA looked good. I will inquire about lab results soon.

I definitely agree, it would be a lot more convenient to self inject as well as dose every 3.5 days. I am going for my 6th shot on 9/11/17 and I am supposed to have another set of labs on that day. I would like a better set of circumstances however I am unsure where to go. Especially since I have begun treatment at a different facility, Wont they want me to come off and retest me? Seems like a pain after I am just getting going. Any thoughts are welcomed.

 

[CoastWatcher]

Hey thanks for the insight. The clinic I am going to did a complete panel. However they just went over the results they were concerned about I guess. They said my potassium was slightly high and retested it. Came back and said it was now within range may have been dehydrated. Mentioned taking a baby asprin. Said my PSA looked good. I will inquire about lab results soon.

I definitely agree, it would be a lot more convenient to self inject as well as dose every 3.5 days. I am going for my 6th shot on 9/11/17 and I am supposed to have another set of labs on that day. I would like a better set of circumstances however I am unsure where to go. Especially since I have begun treatment at a different facility, Wont they want me to come off and retest me? Seems like a pain after I am just getting going. Any thoughts are welcomed.

No doctor who understands androgen management would discontinue TRT when you transferred to their care from another practice. Provide them with your medical records, particularly your baseline, pre-treatment lab work, and you can make an easy transition.

You're dealing with a practice that's years behind the standard of care you deserve.

 

[Mrfrieze]

No doctor who understands androgen management would discontinue TRT when you transferred to their care from another practice. Provide them with your medical records, particularly your baseline, pre-treatment lab work, and you can make an easy transition.

You're dealing with a practice that's years behind the standard of care you deserve.

When you say I am dealing with a practice years behind, are you saying in general or in regards to the protocol the T clinic put me on?

 

[CoastWatcher]

When you say I am dealing with a practice years behind, are you saying in general or in regards to the protocol the T clinic put me on?

Their approach to TRT isn't one that makes a great deal of sense.

They started with a loading dose, so to speak, and then began tapering down. Why? The body seeks stability...week over week manipulation of the dose administered means that serum levels (which are in flux simply because exogenous testosterone is in play, shutting down your natural axis) are going to be measured at the end of a roller-coaster ride of dose changes. T-mills do this because their patients don't know any better and a whopper of a dose means they may "feel" something more quickly and be impressed. But at six weeks you'll have a snap shot of...multiple changes. Not a picture reflecting a stable protocol.

What was your SHBG value? A good doctor takes a look at that, along with total and free testosterone and determines how often and how much testosterone should be injected. The typical starting protocol is an injection every 3.5 days, twice a week, with anywhere from 50-80mgs of testosterone in each injection. SHBG influences this - patients with lower scores typically require smaller and more frequent injections than patients with higher values. If you have low SHBG big, single doses will frustrate your efforts and could certainly spike your estradiol. If things have been stable for six weeks it is far easier to modify the various elements. Increase the number of injections, decrease or increase the amount of testosterone per injection, add an AI, or modify the amount already taken.

I certainly wish you great success, but it frustrates me when I see someone not getting the care they deserve. On top of the few points I've made about your protocol, it doesn't seem that your being seen as a partner in your care. You've not been given lab results, which limits your understanding of what your clinical picture is, and you have to take time and drive to the office every week for a shot. I know there is a better option for you.

 

[Mrfrieze]

Their approach to TRT isn't one that makes a great deal of sense.

They started with a loading dose, so to speak, and then began tapering down. Why? The body seeks stability...week over week manipulation of the dose administered means that serum levels (which are in flux simply because exogenous testosterone is in play, shutting down your natural axis) are going to be measured at the end of a roller-coaster ride of dose changes. T-mills do this because their patients don't know any better and a whopper of a dose means they may "feel" something more quickly and be impressed. But at six weeks you'll have a snap shot of...multiple changes. Not a picture reflecting a stable protocol.

What was your SHBG value? A good doctor takes a look at that, along with total and free testosterone and determines how often and how much testosterone should be injected. The typical starting protocol is an injection every 3.5 days, twice a week, with anywhere from 50-80mgs of testosterone in each injection. SHBG influences this - patients with lower scores typically require smaller and more frequent injections than patients with higher values. If you have low SHBG big, single doses will frustrate your efforts and could certainly spike your estradiol. If things have been stable for six weeks it is far easier to modify the various elements. Increase the number of injections, decrease or increase the amount of testosterone per injection, add an AI, or modify the amount already taken.

I certainly wish you great success, but it frustrates me when I see someone not getting the care they deserve. On top of the few points I've made about your protocol, it doesn't seem that your being seen as a partner in your care. You've not been given lab results, which limits your understanding of what your clinical picture is, and you have to take time and drive to the office every week for a shot. I know there is a better option for you.

I plan on looking for another alternative. I guess I was looking for the path of least resistance. I have had the effects of Low T for so long and I just wanted a quick answer once I actually understood that my issues may be hormonal. Thank you for your insight.

 

[CoastWatcher]

I plan on looking for another alternative. I guess I was looking for the path of least resistance. I have had the effects of Low T for so long and I just wanted a quick answer once I actually understood that my issues may be hormonal. Thank you for your insight.

Yours is a common story; many of us began treatment with doctors/clinics that were substandard. We can provide a referral if you would like one.

 

[Mrfrieze]

Yours is a common story; many of us began treatment with doctors/clinics that were substandard. We can provide a referral if you would like one.

Absolutely feel free to share.

 

[CoastWatcher]

The simple fact of the matter is that doctors who understand TRT are rare in the United States, and rarer elsewhere in the world (trust me, I live in Canada). You have your typically clueless PCP, your equally clueless endocrinologist, your slightly more knowledgeable urologist, the avaricious T-mill operator...and the hard to find, top of the game doctor. They certainly do exist, the local, first-rate practitioner, but they rare. My own physician here in Toronto told me the amount of time spent on male hormone replacement when she was in med school and residency was paltry. She had to educate herself.

Where in North Carolina do you live? I know that some members there have found local care. That is the first step. You also should consider Defy Medical and Prime Body, national practices with very different delivery models, both are site sponsors, true, both have many satisfied many of our members. If imweremto move to the States I would contact both.

Just plug both organization names into the search box and read the posts. Then call both (Defy is closed for hurricane watch at the moment) and ask hard questions about cost and delivery. But tell us where you live first and perhaps a local provider can be found.

 

[Mrfrieze]

I live in Statesville, about 45 min outside of Charlotte. I am curious about some of the sponsors though. If I went through something like Defy, wonder what I would have to do. Would I just send them a hard copy of my original test results?

 

[CoastWatcher]

I live in Statesville, about 45 min outside of Charlotte. I am curious about some of the sponsors though. If I went through something like Defy, wonder what I would have to do. Would I just send them a hard copy of my original test results?

You would submit your current medical records and (more than likely) have to have additional testing. You would receive guidelines to have a basic physical performed, either by your own doctor or at a walk-in clinic, and that would then be submitted (I believe the physical is an annual requirement). Then a consultation is arranged by phone.

Call them when the hurricane passes the Tampa area, where they are based, and all of it will be emailed and explained. Dr. Justin Saya, the medical director, is highly regarded and a member here. Put his name in the search box to see his posts and threads.