Who Gets Prescribed Testosterone in the Veteran Affairs System?

[Jinzang]

A new study analyzes the characteristics of men who are prescribed testosterone in the Veteran Affairs System. The strongest predictor was the use of opioids.

Only 6.3% of men who received testosterone from the VA during the study period had a disorder of the testis, pituitary or hypothalamus associated with male hypogonadism. Among patients without a diagnosed disorder of hypogonadism, the use of opioids and obesity were the strongest predictors of testosterone prescription. Patients receiving >100 mg/equivalents of oral morphine daily ) and those with body mass index (BMI) >40 kg/m[SUP]2[/SUP] were more likely to receive testosterone than non-opioid users and men with BMI <25 kg/m[SUP]2[/SUP]. Certain demographics (age 40-54, White race), comorbid conditions (sleep apnea, depression, and diabetes), and medications (antidepressants, systemic corticosteroids) also predicted a higher likelihood of testosterone receipt.

 

[Jinzang]

This study was reported on in Science Daily. The interview with study's author ended on what sounded to me like a sinister note;

"Our findings highlight the opportunity to intervene at the provider and local level to improve testosterone prescribing practices," Jasuja said. "The VA and other healthcare systems can use these insights to promote targeted efforts that can help decrease inappropriate prescribing of testosterone, while ensuring that those patients who can benefit the most can still receive it."

Sounds like the VA wants to reduce TRT diagnosis.

 

[CoastWatcher]

As Will Brink has noted here, the VA puts their hypogonadal patients through hell. It's shameful.

 

[Weasel]

I did for awhile, Then one day I needed a refill, The doc looked at me like I was crazy and said "the VA doesn't do that" I had been getting it from them for appox 2 years at that point. Long story short, They cut me off cold turkey, would not even acknowledge that I had been getting it from them. I had always been very impressed with the VA up until about a year ago. It went down hill fast about the time they started implementing new regs to combat the poor care the news was always talking about. (go figure) They are of little to no help with actual medical stuff. They'll check your blood pressure and take your temp, maybe run a CBC but that's about the extent of help they are to me anymore.

I finally said **** it and called defy and pay out of pocket now.

 

[Mark]

A few years ago I had my primary care doc at the VA get me tested for low testosterone. Results came back low, 175. Endo wouldn't even see me, they said I was not low enough, even though I had multiple symptoms of hypogonadism. Up until that point the VA had been very good at giving me pills for blood pressure, for thyroid, etc., but for some reason they just don't do testosterone.

Mark

 

[JPB]

Opioids will reduce natural T production.

 

[Dr Justin Saya MD]

Our vets deserve the best care of anyone...and unfortunately that's rarely the case. They need to find a way (through better salary, benefits, perks, etc) to be more competitive in the market to attract and retain the best and brightest of the providers (across all disciplines).

Of course eliminating or improving some of the bureaucratic nonsense would help too...

 

[Weasel]

I had a very interesting experience yesterday. I was at the VA to get my annual Defy physical completed, Which has never been an issue before. Well yesterday all the sudden it was a huge issue. he asked me so many questions about Defy and what the form was all about that I finally just said, "I'm not making you fill that out, if you don't want to, then don't." He gave me a death stare and said there was no reason for me to be on testosterone and that I was playing with fire but continued to fill out the form.
I was so close to say that "you and your 48% body fat are the one who's playing with fire"

Before He would hand me back my paperwork for Defy, He insisted on making a copy "for my records" I've no doubt he has some ulterior motive by making the copy.


I'm going to wait a month and then request a full copy of my VA medical records to see just exactly what he put in my file.


The VA system becomes more of a joke with each visit. And I used to be the one who defended the VA.

 

[Vince Carter]

Once I got my disability rating I ran...I'm fortunate to thru work have a great plan that is very affordable for me. I find no reason to even set foot in the VA system unless they muck up my disability compensation, which they haven't. Yet.

But Weasel's experience is another reason to call it a Wellness Exam or a work physical, the prejudice comes right to the top in many cases when you say HRT. I take Defy's sheet and whiteout their names and such and make some copies and use those and ask for a wellness exam. And my insurance covers it.

 

[hva]

I had a very interesting experience yesterday. I was at the VA to get my annual Defy physical completed, Which has never been an issue before. Well yesterday all the sudden it was a huge issue. he asked me so many questions about Defy and what the form was all about that I finally just said, "I'm not making you fill that out, if you don't want to, then don't." He gave me a death stare and said there was no reason for me to be on testosterone and that I was playing with fire but continued to fill out the form.
I was so close to say that "you and your 48% body fat are the one who's playing with fire"

Before He would hand me back my paperwork for Defy, He insisted on making a copy "for my records" I've no doubt he has some ulterior motive by making the copy.


I'm going to wait a month and then request a full copy of my VA medical records to see just exactly what he put in my file.


The VA system becomes more of a joke with each visit. And I used to be the one who defended the VA.

You can see your VA med record online. There's a 3 day hold after any visit but it's all on there.

www.myhealth.va.gov/

That being said. I use the VA for a lot of things, but TRT is not one of them and I never even gave them a serious thought for this.

 

[Weasel]

Once I got my disability rating I ran...I'm fortunate to thru work have a great plan that is very affordable for me. I find no reason to even set foot in the VA system unless they muck up my disability compensation, which they haven't. Yet.

But Weasel's experience is another reason to call it a Wellness Exam or a work physical, the prejudice comes right to the top in many cases when you say HRT. I take Defy's sheet and whiteout their names and such and make some copies and use those and ask for a wellness exam. And my insurance covers it.

excellent. I'll have to do the same from now on.

 

[Nelson Vergel]

Sub Optimal Testosterone Study from VA Hospital Exposes Veterans to Higher Risks

 

[Nelson Vergel]

ExcelMale.com Identifies Major Flaws in Recently Published VA Testosterone Study

 

[Dr Justin Saya MD]

That being said. I use the VA for a lot of things, but TRT is not one of them and I never even gave them a serious thought for this.

Sad to say, a wise decision.

 

[usmarine3533]

I'm glad I saw this thread. I was about to ask my primary at the VA if the VA would pay for my TRT.

 

[blackebob]

Once I got my disability rating I ran...I'm fortunate to thru work have a great plan that is very affordable for me. I find no reason to even set foot in the VA system unless they muck up my disability compensation, which they haven't. Yet.

Sadly, as a veteran, I had the same reaction. Don't ask any other questions don't file any more paperwork just shut your mouth and walk out the door.