New Member - Looking for TRT Docs in Ontario, Canada

AR

New Member
Hello everyone,
Found this site a couple of weeks ago and have been checking out the posts and trying to educate myself on where I should start and if TRT is the way to go for me. Some great information and been great learning from everyone with their case histories.

I am 43, a father of a 3 yr old and with another one on the way. Married for last 6 years. Run my own business part time and work part time as a supply teacher. Have been feeling pretty tired the last 3 years. My son really didn't sleep much the first year of his life so thought the fatigue was just the lack of sleep and still trying to run a business. Downsized the business and now son is sleeping well so get 6-8hrs of sleep each night yet still found myself really tired all the time, low motivation to do things, libido has been low last 3-4years. Did have a right hip replacement in Nov. of 2015

I hit the weights 3-4 times per week, do cardio 2-3 times per week and 70-80% of the time each a good nutrient dense diet with fairly high protein/fat. Despite, this have not seen as much improvement in fat levels going down or weight moving much. Recently cut off coffee as found was too dependent for an energy pick me up.

I am 5, 8", weigh 188 this morning and bodyfat roughly 23%. Have always struggled in putting on muscle mass and when try to lose fat, tend to lose muscle/strength as well despite trying to keep the weights
up.

Supplements I currently take:
D3-10,000 IU 3-4 times per week (was taking 50, 000 IU since D levels were low on last blood work. Has improved energy levels.)
Thorne B Complex (1 a day)
Meriva HP from Thorne (Curcumin) (1 a day)
Omega 3 Liquid Fish Oil (1 tsp a day)
1 Thorne Multi

Growing up, I played lots of soccer. Some concussions through this along with a soccer ball or two to the testicles. Never had them checked for damage but remember one incident was sore for a good week or two in my mid 20's. Also, trained and competed in kickboxing for a period of 15 years, with the competitive side being over about 5 years. Many blows to the head from sparring/competing, with serious concussions causing me to quit in 2005.

In early June, went to my family doctor and asked to have my testosterone checked along with a few other markers as hadn't had any blood work in a couple of years. This was done via Life Labs.

Asked to get referred out to see an Endo. Saw here about 3 weeks ago and bascially dismissed me saying I am in range and didn't think testosterone would help me despite all my symptoms and past history.

I am willing to go over the border and get more specific blood work through Discounted labs and will post here once I do so. Hope someone can provide a doctor or two I can get a referral to. I am in Southwestern Ontario.

Hematology
#5639
WBC 4.8 4.0 - 11.0 x E9/L
RBC 4.84 4.50 - 6.00 x E12/L
Hemoglobin 140 135 - 175 g/L
Hematocrit 0.42 0.400 - 0.500 L/L
MCV 86 80 - 100 fL
MCH 28.9 27.5 - 33.0 pg
MCHC 337 305 - 360 g/L
Platelets 204 150 - 400 x E9/L
RDW 13.5 11.5 - 14.5 %
Differential
Neutrophils 2.7 2.0 - 7.5 x E9/L
Lymphocytes 1.6 1.0 - 3.5 x E9/L
Monocytes 0.4 0.2 - 1.0 x E9/L
Eosinophils 0.1 0.0 - 0.5 x E9/L
Basophils 0.0 0.0 - 0.2 x E9/L
Biochemical Investigation of Anemias
#5687
Ferritin HI 291 22-275 ug/L
General Chemistry
Glucose Fasting 5.4 3.6 - 6.0 mmol/L
Hemoglobin A1C/Total Hemoglobin 5.3 <6.0 %


Creatinine 94 67-117 umol/L
Glomerular Filtration Rate (eGFR) 85


An eGFR from 60-89 ml/min/1.73 m2 is consistent
with mildly decreased kidney function. However,
in the absence of other evidence of kidney
disease, eGFR values in this range do not fulfill
the KDIGO criteria for chronic kidney disease.
Interpret results in concert with ACR measurement.
For patients of African descent, the reported
eGFR must be multiplied by 1.15.
Effective May 4 2015, eGFR is calculated using
the CKD-EPI 2009 equation.
KDIGO 2012 guidelines highlight the importance of
eGFR and urine albumin creatinine ratio (ACR) in
screening, diagnosis and management of CKD.
Results for eGFR should be interpreted in concert
with ACR.
Urate 418 230-480 umol/L
Alanine Aminotransferase 28 <50 U/L
Lipids
Hours After Meal 13 Hours
Triglyceride 1.11 mmol/L
Cholesterol 5.50 mmol/L
HDL Cholesterol 1.63 mmol/L
Non HDL Cholesterol 3.87 mmol/L
Non HDL-Cholesterol is not affected by the
fasting status of the patient.
LDL Cholesterol 3.37 mmol/L
Consider the non HDL-C value as an alternate
lipid target if monitoring treatment in
intermediate or high risk patients.
Cholesterol/HDL Cholesterol 3.4
Lipid Target Values Lipid Target Values should be based on patient
10 year CVD risk assessment.
! High or Intermediate CVD risk
-----------!-----------------------------------
Primary ! LDL-C < or = 2.0 mmol/L OR
Tx target ! > or = 50% decrease in LDL-C


Thyroid Function
Thyroid Stimulating Hormone [TSH] 1.04 0.32-4.00 mIU/L


Tumour Markers
Prostate Specific Antigen 0.70 <4.0 ug/L
Methodology: Abbott Architect immunoassay.
Results should not be interpreted in isolation as
absolute evidence of the presence or absence of
malignant disease.
Changes in serial results may be misleading
unless all Total PSA results are from the same
laboratory method.


Reproductive and Gonadal
Testosterone 11.3 8.4 - 28.8 nmol/L
Total Testosterone levels may not reflect the
biologically-active testosterone when SHBG levels
are abnormal.


Bone Markers
25-Hydroxyvitamin D 84 75 - 250 nmol/L
Season, race and dietary intake affect 25-Hydroxy
Vitamin D levels. Highest levels are found in
the summer months and lowest levels during the
winter.
 
Thanks CoastWatcher. Much appreciated. I will get my GP to get a referral to Dr. Greenspan.

A doctor friend of mine recommended Dr. Adam Millar. Have you heard good things about him?
 
Thanks CoastWatcher. Much appreciated. I will get my GP to get a referral to Dr. Greenspan.

A doctor friend of mine recommended Dr. Adam Millar. Have you heard good things about him?
He has a solid reputation, very knowledgeable. I have heard that he is highly selective in who he sees. I have one friend who had his family doctor submit the referral and was told he didn't qualify for TRT - on the basis of his lab work alone! He may be a wiz...but that struck me as absurd.
 
That is odd. I will aim to get a referral to Greenspan then. Do doctors mind if you bring lab work in from the US as I was planning on heading over to Michigan to go the needed blood work while I wait for my referral?

Thanks again!
 
Thanks for the welcome Madman. I have been reading your past posts and have learned a lot. Thanks for sharing your experience and what to potentially expect with Greenspan. Hope I can get a second opinion and a referral from my GP.

Yeah, never really occurred to me that my testosterone would be so low at my age but the more read the more I figured it might be the reason for my symptoms especially with all the concussions I have had in the past. I told all this to the endo plus that my levels were that of an 80yr old really and she just stuck to the numbers and said I was in range. Quite disappointing actually!

You guys are actually really giving me hope that I can feel much better and have a full life with my boys and not just turn into a frail old man. I have to try and keep up :)

Thanks again for your input. Hope to post my numbers soon as hope to head over to the states soon to get all the needed blood work done.
 
Thanks for the welcome Madman. I have been reading your past posts and have learned a lot. Thanks for sharing your experience and what to potentially expect with Greenspan. Hope I can get a second opinion and a referral from my GP.

Yeah, never really occurred to me that my testosterone would be so low at my age but the more read the more I figured it might be the reason for my symptoms especially with all the concussions I have had in the past. I told all this to the endo plus that my levels were that of an 80yr old really and she just stuck to the numbers and said I was in range. Quite disappointing actually!

You guys are actually really giving me hope that I can feel much better and have a full life with my boys and not just turn into a frail old man. I have to try and keep up :)

Thanks again for your input. Hope to post my numbers soon as hope to head over to the states soon to get all the needed blood work done.


You have every reason to on to be hopeful in this regard. Almost all of us felt dismal, and we experienced the medical run-around as we learned how little doctors actually know about male androgens. It's more difficult, for many reasons, to get the care we need here in Canada, but it can be done.
 
Hi Madman,
Finally got my referral to Dr. Greenspan and see him next Wednesday. Curious if you can tell me a bit more about his approach and what sort of treatment he has given you and how your numbers have turned around? Any input would be greatly appreciated.
Thanks,
AR
 
Hi madman,
Wow. Thanks so much for sharing all the great info. Makes me feel more prepared going in. My biggest issues is libido as it is pretty much non existent. Energy has been up and down but find I get wiped out from my workouts even if I just push a little harder. Hard to make progress when I feel I have to do everything perfect when it comes to eating and training.

I am really doing this for my boys. Being an older father I don't want them to remember me as the someone who couldn't do anything with them or keep up. I want to have lots of vitality and be physically active with them. A big plus as well it will help a great deal with my marriage as having very low libido does not make for a very loving relationship.

Again, thanks again for sharing and will let you know how it goes.

Take Care,
AR
 
Just make sure you mention that physical activity fatigues you and do not emphasize workouts/recovery, stick to your main symptoms as most doctors are not concerned with whether you have poor recovery from intense weight training sessions or are concerned that you have a hard time gaining muscle in the gym.
 

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