The usual run around

[BobF]

Greetings to all.

Been on TRT for over 20 years; compounded, injectable, transdermal. Was involved in an explosion containing Dioxin, since that moment always in TRT.

Unfortunately, all the years of it I became pretty "sensative" to where my H&H became problematic. The usual blood bank trip every 8 weeks wasn't enough.

My Dr retired, in steps new ones and I was removed from Test. Been almost a year now with none, I have been increasingly returning to the time that I was originally given Test, I have significant memory issues, brain fog, cognitive skills lapse, anxiety, depression.... just to name but a few.

My Endocrinologist is excellent, but for this he is not and denying TRT, states that I am 58, part of life. Same with my Internist, same with my Urologist and so on. Seems when you are in your late 50s, quality of life is not something they care about.

So I have enclosed my last labs. Lots of Free and Bioavailable, low SHBG and Total. They are all relying on the Free and Bio numbers. It's my understanding that the SHBG should have more bound and my Total should be much higher with a lower Free and Bio. I also understand as we age the SHBG goes much higher, yet mine is in the tank.

What I am seeking please, is for an explanation other than "you are hypogonadal" . I have been all over the internet and journals, but nothing is appearing to cover this issue in particular.

I greatly appreciate any assistance.

Kind Regards

Bob

 

[mooseman109]

Good title to thread. You know you better than they know you. Seems to be the case with a lot of Dr's not really wanting to branch out and know more than what they learned in medical school however long ago. My advice is to go your own way regarding TRT treatment. I went with Defy and am happy with the telemedicine approach. they are knowledgable in this field.

 

[Cataceous]

That's an absurd "normal" range for the Vermeulen free testosterone calculation. We would typically see that guys can start to have symptoms of low testosterone when this number falls below 10 ng/dL. Yet that's the top of their range! Looking at the more modern Tru-T calculator, we find that your free testosterone is about 7 ng/dL. The healthy normal range is 16-31. You are pretty severely hypogonadal, and one must question the competency of any doctor who says otherwise.

If you're US-based then Defy Medical is highly recommended. Prices are reasonable and the staff is very knowledgeable.

 

[DragonBits]

Greetings to all.

Been on TRT for over 20 years; compounded, injectable, transdermal. Was involved in an explosion containing Dioxin, since that moment always in TRT.

Unfortunately, all the years of it I became pretty "sensative" to where my H&H became problematic. The usual blood bank trip every 8 weeks wasn't enough.

My Dr retired, in steps new ones and I was removed from Test. Been almost a year now with none, I have been increasingly returning to the time that I was originally given Test, I have significant memory issues, brain fog, cognitive skills lapse, anxiety, depression.... just to name but a few.

My Endocrinologist is excellent, but for this he is not and denying TRT, states that I am 58, part of life. Same with my Internist, same with my Urologist and so on. Seems when you are in your late 50s, quality of life is not something they care about.

So I have enclosed my last labs. Lots of Free and Bioavailable, low SHBG and Total. They are all relying on the Free and Bio numbers. It's my understanding that the SHBG should have more bound and my Total should be much higher with a lower Free and Bio. I also understand as we age the SHBG goes much higher, yet mine is in the tank.

What I am seeking please, is for an explanation other than "you are hypogonadal" . I have been all over the internet and journals, but nothing is appearing to cover this issue in particular.

I greatly appreciate any assistance.

Kind Regards

Bob

If you really want to stick with your current doctor for TRT, you could get the

Testosterone, Free, Equilibrium Ultrafiltration test which would give you a true reading of Free T, which should be low. Vs the calculated free T result.

What gets me, if your total T was 250 BUT your free T was low, they the doctor would say your total T was too high for TRT.

I thought most doctors only went by the total T result !

 

[Systemlord]

My Endocrinologist is excellent, but for this he is not and denying TRT, states that I am 58, part of life.

I don't understand what is wrong with these doctors, quality of life is lost on them. When people are told their heart or kidney is failing, they don't take the position it's part of life and are told to deal with it, the organ is replaced and life goes on.

Defy Medical is an ideal path to take because it seems our healthcare system is falling us in regards to quality of life.

 

[Vtail]

I don't understand what is wrong with these doctors, quality of life is lost on them. When people are told their heart or kidney is failing, they don't take the position it's part of life, the organ is replaced and life goes on.

We never had a health care system. It's a great sick care system especially in the USA, in that if you're dying they will keep you alive. But that's about it unfortunately. This really starts to hit home as we age.

 

[Systemlord]

By many measures we do not rate favorably when compared to other industrialized societies. Our behavior and lifestyle make us prone to illnesses that are chronic, complex, lifelong, and life shortening, all of which make them very expensive to treat.

We spend almost $8,000 per person per year, about 50 percent more than the next closest developed country, and this cost is seriously and affecting businesses, government and each of us. The premiums are high, the benefit is low. It is a zero-sum game.

They are just treating the worst cases and leaving those with chronic conditions are left to suffer, a perfect example is in another thread where a 58 year old is being refused TRT after being on it for 20 years and the endocrinologist who is taking the position that low-T is a part of aging and deal with it.

 

[BobF]

I have 30 years as a Firefighter Paramedic, so I am educated in medicine, even more so than most, but the hormones trips me up mainly due to my memory.

20 years ago I was caught in an explosion containing Dioxin aka a form of Agent Orange or Roundup. Destroyed my system pretty bad, was blown off then by many doctors. Was in prep for my first bodybuilding show, my wife is an IFBB Pro Figure. So a year plus was spent finding a ear that would listen, and did. Sadly, I never felt that great, good but never great.

At that time my calcium was high and occasionally my Parathyroid, non related to Thyroid. Again non would listen, just a lab error, etc. For the next 20 years I would see my health, my memory, brain fog severe, couldn't recall friends and families names. Simple math gone as my family had many Masters Degrees in mathematics. Rage, anxiety, depression....kept it all together until last year when I wanted to end it. Doctors still wouldn't listen like before, my Testosterone doc retired, I knew I Hyperparathyroidism but no one would test me.

Eventually got retired doc to do it, I was severe. Third Stage renal failure had set in, arrythmias, extremely severe memory, and a lot of unmentionables. Finally found an Endo 3 hours south from me that would agree, fact is he made me go to the hospital then and there for all the scans and then sent me to UCLA for consult for surgery.

Was the worst case she had ever seen in the thousands she had performed as a head and neck high risk specialist. I was a month away from a probable coma from all the calcium on my brain.

Post surgery I felt incredible, best in the many decades, but then I started to backslide and it's the Testosterone. So my moment in Heaven was once again destroyed by hypogonadism. Doctors are stressed over cancer possibilities, not the memory is shit again. Was hoping to return to what I wanted which is the stage for bodybuilding for my 60th birthday. So my docs are saying enjoy what you now have, could have been worse.

It's a very long story, involved a team from Virginia Tech, USC, UCSF, Valley, Texas Tech, Olestra potato chips and dry sauna. Learned decades ago what we would see today in Environmental Estrogens, decline of fertility, the pollution with Dioxin in our entire food chain... It's been a ride

 

[xqfq]

If you really want to stick with your current doctor for TRT, you could get the

Testosterone, Free, Equilibrium Ultrafiltration test which would give you a true reading of Free T, which should be low. Vs the calculated free T result.

What gets me, if your total T was 250 BUT your free T was low, they the doctor would say your total T was too high for TRT.

I thought most doctors only went by the total T result !

If I was in your shoes, this is what I’d do. Get the better test and print out the results for your doctor to make it really easy. If he’s a good (which in my mind means understanding rather than infinitely knowledgeable) endo as you say then it should be straightforward from there. I don’t think most of these doctors are following the research about the free testosterone assays.