This YouTube Video Shows How a Doctor Can Mess You Up
- Thread starter Vince
- Start date
FrankUnderwood
New Member
i wanted to comment on that video when i saw it posted on Youtube yesterday, and a few other videos of his.
personal opinion - his doctor does *not* understand the finer points of male HRT/TRT and is shooting in the dark with these wide ranging changes. i do not believe she is knowledgeable in the most up to date treatments for his issues and is likely doing him a disservice. at a minimum, an AOC between his doc and Dr Saya or Dr Crisler could help him tremendously.
i wish him well, and wish he would find a competent MD.
personal opinion - his doctor does *not* understand the finer points of male HRT/TRT and is shooting in the dark with these wide ranging changes. i do not believe she is knowledgeable in the most up to date treatments for his issues and is likely doing him a disservice. at a minimum, an AOC between his doc and Dr Saya or Dr Crisler could help him tremendously.
i wish him well, and wish he would find a competent MD.
I've been following virtually all of his videos and he indeed does follow up with bloodwork on a frequent basis, and HAS seemed to report feeling well on progressively lesser doses.
We'll see what his blood work shows after a month or so on the lesser (again) dose.
I don't think she's a bad doc.
We'll see what his blood work shows after a month or so on the lesser (again) dose.
I don't think she's a bad doc.
Vince Carter
Banned
Single biggest flaw I see here is that I'm not seeing a woman to get my male hormones straight. There are things there that she just can't comprehend outside of numbers on lab tests.
Now, I see plenty of things he was probably doing wrong and props to him he thinks he's doing great. Things in the second video he omits, there's ZERO talk of his Estradiol. No talk about Erections or Libido, this very subjective "I feel great!", and obviously he does just by observing him. And there's always the wild card of what the individual wants, needs, and responds to. There's just too much talk of ONLY Testosterone here that I'm deeply skeptical of what his Dr is doing, it's contradictory to my learned position on HRT.
Now, I see plenty of things he was probably doing wrong and props to him he thinks he's doing great. Things in the second video he omits, there's ZERO talk of his Estradiol. No talk about Erections or Libido, this very subjective "I feel great!", and obviously he does just by observing him. And there's always the wild card of what the individual wants, needs, and responds to. There's just too much talk of ONLY Testosterone here that I'm deeply skeptical of what his Dr is doing, it's contradictory to my learned position on HRT.
Vince Carter
Banned
Thing is, you won't see it. and I don't disagree she's good, or bad, but in this environment of HRT we're always looking at tests and this guy isn't putting up a single documented test for peer review. If I'm missing that then please set me straight.
Isn't the goal of TRT to feel good? or is it to chase numbers on a lab report?
Vince Carter
Banned
That's not what I said. I can make a video and say I'm great and I'm fantastic and that X regimen works me...It's completely unsubstantiated. And we post labs here all day long so try again with your comment.
Vince Carter
Banned
as a disclaimer, I did not and won't put 33 minutes in to his video to dissect his business.
I stand by my comment, if I'm feeling great I really don't care what my lab report says, I'm not going to change anything.
He doesn't post his results but he discusses the values in similar videos with his Dr. She's pretty thorough, it seems. But, this is why it's called the "art of medicine". Individual treatment philosophies and plans of care do differ depending on patient, and more likely physician, differences.......
John O'Connor
Member
I think the criticism should be directed toward the current TRT clinical guidelines, more than this guy or his current doctor.
I've watched a lot of his videos before discovering ExcelMale. Let's realize, Bignoknow's father is a pediatrician, and also makes very informative YouTube videos (filmed by his son.) https://www.youtube.com/user/paulthomasmd
His father has 113K subscribers. Bignoknow has 31K subscribers.
Bignoknow's YouTube channel is basically a documentary of his personal struggle with depression/anxiety, and realization that he was hypogonadal. His 1st video was 4/25/2012, and he has come a long way since then.
He has only been with Dr. Erica Zelfand for the last year of so. His original doctor never checked his FSH or LH prior to putting him on TRT. And after years of TRT, Dr. Zelfand suspected he was originally misdiagnosed as primary hypogonadism, as opposed to secondary. Here is their first video together (3/24/15). https://www.youtube.com/watch?v=VK81LOPNKG0
Video (4/9/15) with his dad discussing new diagnosis of hypothyroid with TSH of 4.8. 2012 clinical guidelines suggest TSH of 10.0 or above should be treated, but below 10.0 is questionable. Again the clinical guidelines suck.
https://www.youtube.com/watch?v=I8wKiwzRvZw
Note, I was diagnosed with high TSH in 2006 (TSH 3.8), and had ED issues since 2000, which low dose Viagra solved. I had Testosterone checked in 2000 (no #s, but "your normal"), 2012 (TT 351, FT 51, and told you are close, but still normal). Finally in 2015 (341 and for the first time a doctor finally checked LH & FSH which were both very high.)
Again - who's fault are my years of not being diagnosed? I blame it on the clinical guidelines. Does this mean Dr. Zelfand is perfect? No, but she's not a TRT specialist either. These doctors from Defy & Prime Body have 100x experience treating patients like us.
I have a lot of respect for Dr. Erica Zelfand, Dr. Paul Thomas, and Bignoknow for sharing the knowledge the do have. I think we should invite them to participate with ExcelMale, Prime Body & Defy to learn more. We are all on a journey of learning.
I've watched a lot of his videos before discovering ExcelMale. Let's realize, Bignoknow's father is a pediatrician, and also makes very informative YouTube videos (filmed by his son.) https://www.youtube.com/user/paulthomasmd
His father has 113K subscribers. Bignoknow has 31K subscribers.
Bignoknow's YouTube channel is basically a documentary of his personal struggle with depression/anxiety, and realization that he was hypogonadal. His 1st video was 4/25/2012, and he has come a long way since then.
He has only been with Dr. Erica Zelfand for the last year of so. His original doctor never checked his FSH or LH prior to putting him on TRT. And after years of TRT, Dr. Zelfand suspected he was originally misdiagnosed as primary hypogonadism, as opposed to secondary. Here is their first video together (3/24/15). https://www.youtube.com/watch?v=VK81LOPNKG0
Video (4/9/15) with his dad discussing new diagnosis of hypothyroid with TSH of 4.8. 2012 clinical guidelines suggest TSH of 10.0 or above should be treated, but below 10.0 is questionable. Again the clinical guidelines suck.
https://www.youtube.com/watch?v=I8wKiwzRvZw
Note, I was diagnosed with high TSH in 2006 (TSH 3.8), and had ED issues since 2000, which low dose Viagra solved. I had Testosterone checked in 2000 (no #s, but "your normal"), 2012 (TT 351, FT 51, and told you are close, but still normal). Finally in 2015 (341 and for the first time a doctor finally checked LH & FSH which were both very high.)
Again - who's fault are my years of not being diagnosed? I blame it on the clinical guidelines. Does this mean Dr. Zelfand is perfect? No, but she's not a TRT specialist either. These doctors from Defy & Prime Body have 100x experience treating patients like us.
I have a lot of respect for Dr. Erica Zelfand, Dr. Paul Thomas, and Bignoknow for sharing the knowledge the do have. I think we should invite them to participate with ExcelMale, Prime Body & Defy to learn more. We are all on a journey of learning.
John O'Connor
Member
Yes everyone is different, but numbers do matter. Sharing them help others understand the full picture of what could possibly be needed to improve their TRT protocal. Total T, Free T, SHBG, DHEA-S, Estradiol Sensitive, FSH, LH, HGB, HCT, Vitamin D, TSH, Free T3, Free T4, Reverse T3, etc.
Bignoknow would be the 1st to admit he did not fully understand or have complete blood work done when first diagnosed with hypogonadism in 2012. Even his most recent lab updates show him trying to lower his cypionate dose, and possibly adding HCG. His doctor is trying to help, but does not have the level of experience of Defy, or Prime Body.
Dr. Erica Zelfand most recently suggested he lower his current dose of cypionate, and possibly switch back to weekly injections instead of E3.5D. This is because the clinical guidelines never mention E3.5D dosing. She is also considering adding HCG to his regimen, but again she probably doesn't understand HCG peaks at 48 hours. I think she is a great doctor, who just needs to learn the intricacies of TRT. The clinical guidelines suck - so its not her fault.
And they do cover his specific labs, but she doesn't seem to be checking SHBG, DHEA, etc. Again - the clinical guidelines don't mention these - so how would any doctor know?
Bignoknow would be the 1st to admit he did not fully understand or have complete blood work done when first diagnosed with hypogonadism in 2012. Even his most recent lab updates show him trying to lower his cypionate dose, and possibly adding HCG. His doctor is trying to help, but does not have the level of experience of Defy, or Prime Body.
Dr. Erica Zelfand most recently suggested he lower his current dose of cypionate, and possibly switch back to weekly injections instead of E3.5D. This is because the clinical guidelines never mention E3.5D dosing. She is also considering adding HCG to his regimen, but again she probably doesn't understand HCG peaks at 48 hours. I think she is a great doctor, who just needs to learn the intricacies of TRT. The clinical guidelines suck - so its not her fault.
And they do cover his specific labs, but she doesn't seem to be checking SHBG, DHEA, etc. Again - the clinical guidelines don't mention these - so how would any doctor know?
Last edited by a moderator:
John O'Connor
Member
Re-ride, do you realize PCPs are taught to follow the clinical guidelines - and taught to ignore the information patients bring in as a result of their google search. That makes sense right?
I mean when endocronologists can't even agree on upper limit of TSH as 3.0, 4.2. 4.5, 5.0 or 10.0 - how do you criticize a doctor who is taught to follow the guidlines?
"When to treat hypothyroidismAlthough there is general agreement that patients with primary hypothyroidism with TSH levels above 10mIU/L should be treated..." from page 1002. https://www.aace.com/files/final-file-hypo-guidelines.pdf
I mean when endocronologists can't even agree on upper limit of TSH as 3.0, 4.2. 4.5, 5.0 or 10.0 - how do you criticize a doctor who is taught to follow the guidlines?
"When to treat hypothyroidismAlthough there is general agreement that patients with primary hypothyroidism with TSH levels above 10mIU/L should be treated..." from page 1002. https://www.aace.com/files/final-file-hypo-guidelines.pdf
John, The docs feel terrorized by the government and harassed by the insurance companies. They've stated as much. I just spent an hour on the phone with my insurer. Pharmacy can't get approval on an essential med I've long been prescribed for the following reason:
"Doctor sent in the proof of medical necessity. He failed to indicate where the medicine was being kept and if it was administered by the doctor or pt self-administered."
The Rx states "Take 4 capsules a day"
Does she really think there is a chance in hell that a pt is going to drive to the doctor's office to have the nurse give him a pill 4 a day seven days a week?
The insurance specialist then said she also needed to know how many capsules a month I take. I replied that I wasn't very good at arithmetic. After about 10 minutes she determined that 4 x 30 =150. I asked her if she was sure. She said yes.
For all those still seeking TRT through the U.S. "health" care system you have my condolences.
Get good medical management. Pay cash. Might help keep you from being tracked along with sex offenders and child molesters.
Enjoy the music.
https://youtu.be/YpJAmlnBxoA
"Doctor sent in the proof of medical necessity. He failed to indicate where the medicine was being kept and if it was administered by the doctor or pt self-administered."
The Rx states "Take 4 capsules a day"
Does she really think there is a chance in hell that a pt is going to drive to the doctor's office to have the nurse give him a pill 4 a day seven days a week?
The insurance specialist then said she also needed to know how many capsules a month I take. I replied that I wasn't very good at arithmetic. After about 10 minutes she determined that 4 x 30 =150. I asked her if she was sure. She said yes.
For all those still seeking TRT through the U.S. "health" care system you have my condolences.
Get good medical management. Pay cash. Might help keep you from being tracked along with sex offenders and child molesters.
Enjoy the music.
https://youtu.be/YpJAmlnBxoA
John O'Connor
Member
I agree - insurance companies suck just as much as the current TRT & Thyroid guidelines. 
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