Doctor being stubbord...

[DrmChld]

Doctor being stubborn...

Hi all,

Kroms referring me here

I am 28, recently had my blood tests done and my total testosterone level was 311. The referance range was 280-800. Now this seemed to be on the low side in my eyes, but my PCP says my levels are fine for my age.

I have been experiencing problems with being exhausted all the time, low sex drive, ED, anxiety, depression.

My PCP doesn't feel I need to be seen by an endo doc to get more tests done.

Any ideas how to get my PCP to refer me out to an endo? Should I just look for a new PCP on my insurance plan?

Any help would be great. I want to feel like a normal person again.

Thanks

 

[Kroms_laugh]

Finding a GP that will work with you (or even work with SWALE) on HRT is what you need. My GP has agreed to work with SWALE and take over the medical supervision of my HRT.

If it were me, the next step would be to make an apt. with a GP that will interpret your past blood work and make a decision based on that. You will have to get some more tests (more blood tests, maybe a semen analysis or even an MRI).

 

[HeadDoc]

DC, if the doc did not treat with test or dx hypogonadism, what did he diagnose? What treatment did he propose?

How's you diet and exercise these days? Been under alot of stress these days?

 

[DrmChld]

DC, if the doc did not treat with test or dx hypogonadism, what did he diagnose? What treatment did he propose?

How's you diet and exercise these days? Been under alot of stress these days?

No diagnosis at all. I went in basically to find out why I have been tired all the time. I explained to the doctor about the research I have done and what problems I have been having.

Per my suggestions she tested my thyroid and testosterone levels. Said they were normal and thats it. Now I have to do another follow up appointment to get her to look further.

I'm self-employed so stress is an everyday thing. Been doing this for 9 years now in the last year or so is when I started having problems.

I follow a strict clean, high protien, good carb only diet. I am almost 8 months post-op from having RNY gastric bypass surgery and down 100 pounds. So basically I eat every hour just to be able to keep my body fueled or I feel even more dragging all day.

I excersize 3 days a week for 90 minutes. This consists of 20 minutes of cardio and then weights been doing this for years.

 

[Kroms_laugh]

DC, if the doc did not treat with test or dx hypogonadism, what did he diagnose? What treatment did he propose?

Good point, Doc.

 

[cjsabbath]

Hi all,

Kroms referring me here

I am 28, recently had my blood tests done and my total testosterone level was 311. The referance range was 280-800. Now this seemed to be on the low side in my eyes, but my PCP says my levels are fine for my age.

I have been experiencing problems with being exhausted all the time, low sex drive, ED, anxiety, depression.

My PCP doesn't feel I need to be seen by an endo doc to get more tests done.

Any ideas how to get my PCP to refer me out to an endo? Should I just look for a new PCP on my insurance plan?

Any help would be great. I want to feel like a normal person again.

Thanks

I went through much the same. I took it upon myself to see an endo - which fortunately my insurance allowed me to do w/o a referral.

 

[pmgamer18]

Here read this then print it out and give it to your Dr. Your levels are normal for a 90 yr. old man. She is going by the range and dose not know what she is taking about.
http://www.aace.com/clin/guidelines/hypogonadism.pdf
As for seeing an Endo good luck I have been to a lot of them in the last 21 yrs. and have yet to find one that knows about Low T.
Phil

 

[DrmChld]

Here read this then print it out and give it to your Dr. Your levels are normal for a 90 yr. old man. She is going by the range and dose not know what she is taking about.
http://www.aace.com/clin/guidelines/hypogonadism.pdf
As for seeing an Endo good luck I have been to a lot of them in the last 21 yrs. and have yet to find one that knows about Low T.
Phil

Thanks for all the advice guys. I'm going to try getting a referral to an endo.

With all the money I am spending on gas, co-pays and time off work, Would it be better just to buy some Test Cyp and try 100mg a week and see how it makes me feel? lol

 

[BigPooka]

How far are you from Michigan? If possible just make an appt w/ Swale and save yourself time, money, and a lot of frustration.

Pooka

 

[DrmChld]

I'm in Southern California...

 

[pmgamer18]

Read the sticky on how to find a Dr. and any kind that knows about low T will be good. I think you would be wasting you time seeing an Endo.
Phil

 

[DrmChld]

Read the sticky on how to find a Dr. and any kind that knows about low T will be good. I think you would be wasting you time seeing an Endo.
Phil

My problem is that I have Kaiser Insurance, which means I can basically only see a Kaiser doc.

 

[Weatherlite]

I don't suppose you got some LH and FSH labs done? If your test is that low and your LH is high then that is proof of a problem.

Also though, you may want to look into the RNY. My wife had this done in 2001 so I know a little bit about it. (obviously not as it applies to a man) One thing that REALLY drags her down and makes her lack energy is forgetting her B-12 shot. I have no idea what your doc has you doing but a B-12 shot is absolutely necessary for gastric bypass patients. She takes 1 1/2 ml every month. She's tried splitting that into 2 week doses but it has worked best 1x/month.

As for what may be causing the low T.....well, did you have problems before the RNY? If not then there must be something associated with the surgery. Have you had your cholesterol checked? Too low of cholesterol inhibits T production. Less than 140 total is the "magic" number to avoid going below.

Also, is it possible that they may have nicked a blood vessel supplying blood to the testicles? This would reduce production as well.

Just throwing some ideas out there for you. I'd hate to see you have to go on lifelong TRT if it can be fixed otherwise.

Good luck to ya though. I do hope that you find a PCP who actually knows what they are doing instead of just knowing how to "read" lab results.

 

[DrmChld]

I have no idea what your doc has you doing but a B-12 shot is absolutely necessary for gastric bypass patients. She takes 1 1/2 ml every month. She's tried splitting that into 2 week doses but it has worked best 1x/month.

Thanks for the input... I currently take a daily b6-16-folic acid with zinc sublingual. Cholesterol is 174.

Now just waiting for my next apt with my doc to see what else we can do.

 

[Axl]

That is clearly a PCP that does not know anything about low T!! She only looks at the reference ranges, that's dumm! She hasn't done enough tests to make a good conclusion. This is typical: I've been there. I know what it is like.

Like all the others, I also had to convince my PCP that those reference ranges are not the absolute truth. Anyhow, if you have a good relationsip with your PCP and she is open about receiving more info: show her the AACE guidelines. Secondly, print pages 32 and 40 of this pdf-file and show it to her. The only good reference range FOR YOUR AGE is mentioned in the table: it is the mean value +/- the SD (= standard deviation).
http://www.mh-hannover.de/einrichtungen/biblio/diss1/diss-gorenoi.pdf
(by the way -> the conversionrate -> nmol/l : 0.0347 = ng/dl ).

If you can, convince her to contact Swale or an other good doctor that is up on low testosterone to discuss what she should do. I have concinced my PCP to do so and know we work as a team to tackle my problem. Last month he admitted that no PCP is up on hormones: in medschool they get about 4 hours of class on male hormones........ (this is in Europe. Maybe it's different in the US but I doubt that after all the things I have read on this forum).

Good luck!
Axl

PS. Personally my T-levels were 220 ng/dl. I am 32. I have lost 2 yrs in doing bloodtests at different hospitals to all showed that my T-levels were at 220 ng/dl. I have had 5 bloodtest and 1 Insuline Tolerance Test done (which also showed low HGH values), and still I could not find an endo that wanted to help me: TRT for young people that are "ideopatic" hypogonadal is something most endo's simply just don't dare. They only help the people wtih genetic disorder like the people with Klinefelter etc. Meanwhile my relationship completely messed up because of our non-existant sexlife. The endo's didn't care about that "minor problem". So look for a good AND EXPERIENCED endo or you will just lose your time and money!! Get some good tests done that cover all the aspects of your hormones by a good doc (see sticky above on blood testing).

PPS Sorry about the long post, but it really pisses me off that docs with no experience what-so-ever on TRT give bad advice to their patients. (Glad I got this off my chest).

 

[mxim]

doctor being stubborn? why don't you get stubborn and tell him if you don't get what you want,you'll take your business elsewhere. who the hell is he to tell you what to do., i am serious. he is there to service you,not the other way around.

 

[Kroms_laugh]

doctor being stubborn? why don't you get stubborn and tell him if you don't get what you want,you'll take your business elsewhere. who the hell is he to tell you what to do., i am serious. he is there to service you,not the other way around.

Agreed.

 

[HeadDoc]

yes, outfits like Keiser hate to deal with complaints. They know you are a captured audience. So complain about poor care to the office manager and ask how you can file a formal complaint be cuase the doc did not listen. I worked for 8 years for an outfit modeled on Kaiser. Next as thru your HR dept. how you can file a complaint with Kaiser.