Dr Crisler congratulates himself on receiving an award from a scam organization!!

[HeadDoc]

Can anyone bunk or debunk (now i'm confused) the science behind urinary testing?

look around for comparative studies.

(Pre)analytical imprecision, between-subject varia... [Anal Biochem. 2009] - PubMed result

 

[mqsymth]

The 24hr urine test was required. As a matter of fact Crisler hands you the urine kit as you walk out the door.

Perhaps you're happy with not knowing what your Rhein urine test hormone measures mean and that Crisler knows all and will tell you what to do and you need no explanation but to just blindly follow and bow. But that's your life not mine.

Yes $5 is nothing. But no doctor that I have ever seen has charged me to send or fax me my labs. In addition when I ask a doctor about my labs and what they mean gosh they have no problem spending time and answering my questions...can you imagine that?

Yes $60 for 10min is fair WHEN you have the labs in front of you and can ask important information and get answers. Such is not the case with Crisler.

The Rhein urine test topic is: there are 29 hormonal measures and whether they are of value or not. If they are of value then I think your doctor owes you an explanation of what they mean since he required you to take them.

I don't even know where to begin with this but....

First, nowhere does he require you to do a Rhein 24hr urine test. If your insurance covers the usual blood work like everyone else, he will send the script in to Labcorp/Quest etc...and request the test. Most will do 24hr urine exams also through insurance. I don't recall it anywhere being said you must take a Rhein urine exam or no patient consult?

Then you can have a follow up to go over the results. $5 for some lab results? Yes, my local doctor will give me blood work while I am there at the office no charge if requested. But they are worthless since he never could order the correct hormone labs, won't do a RT3, which I have problems with etc...so I pretty much never ask for lab work from my local doctor.

But I always laugh when people bring this up. $5...are you kidding..let's see, I spent $7 today at Starbucks alone for some green tea, a breakfast sandwich and a pastry...so, hmm..last month, like every month, ATT screwed me for $220 for my two iphones...yes....$5 is going to really put a hurting on somebody, give me a break.

$5 for somebody to file the labs, scan and make a .pdf file and email it to you is nothing. You must work at McDonalds if you think $5 is actaully worth mentioning in this day and age.

The Rhein is OK and gives you a great deal of information for the money at one fell swoop. Again, if your insurance doesn't cover it and you can't afford it, then don't do it, that simple.

As far as the consult, can't talk about that. But, how many doctors have spent more than 10 minutes with you? I had a few over the years, but they won't touch prescribing T, and don't want to do T4/T3 combo. My local doc will do the T4/T3 synthetic, but he stated that it has been shown that adding T3 doesn't do anything more than T4. I just shrug and say call in the script, and he does it. Anything more than a sinus infection, forget it, he is pretty useless as most doctors are related to male hormones and the treatment of such and thryoid.

I had a discussion with a doctor one day when I asked why he was running 1.5hrs behind.

His exact statement: "People don't want to just come in and take their 10 minutes of time and then leave. They want to go on and on asking all sorts of questions."

I said, well, maybe you should allot more time patients than 10 minutes. He just laughed and said, yeah right, to keep this place running with the expenses, it is 10 minutes and we have to move on.

So, I really don't think for $60 for 10 minutes of time, which is what pretty much any standard negotiated doctor rate even through insurance, is off base at all really. Shoot, most specialist such as a ENT will run $100-120 through insurance negotitated rates, and they will give you the 10-15 minutes and then you are pushed out the door. Want an MRI/CAT scan etc?!?! That will run you $400. Get yourself an HSA and let me know how much stuff costs...all of this Obama pie in the sky health care crap is going to cost us all, particularly if you pay a lot in taxes like some of us.

Also, I have always had some type of action planned and pushed the issue with any doctor on what exactly is needed and where do we go from here. If they don't give me that, well, I will let them know. It hasn't come to that yet though personally.

Good luck.

 

[techlogik]

The 24hr urine test was required. As a matter of fact Crisler hands you the urine kit as you walk out the door.

Perhaps you're happy with not knowing what your Rhein urine test hormone measures mean and that Crisler knows all and will tell you what to do and you need no explanation but to just blindly follow and bow. But that's your life not mine.

Yes $5 is nothing. But no doctor that I have ever seen has charged me to send or fax me my labs. In addition when I ask a doctor about my labs and what they mean gosh they have no problem spending time and answering my questions...can you imagine that?

Yes $60 for 10min is fair WHEN you have the labs in front of you and can ask important information and get answers. Such is not the case with Crisler.

The Rhein urine test topic is: there are 29 hormonal measures and whether they are of value or not. If they are of value then I think your doctor owes you an explanation of what they mean since he required you to take them.

Not true, Rhein is NOT required. Just because they handed you a container on the way out of the door and YOU accepted it without question, tells me you didn't say, ummm...that is OK, but you can just call my labs into Quest/Labcorp, or whoever your insurance covers...and make them do it that way. They have never questioned and not sent in labs I have requested them to do.

Do you think Urine testing is useless? Particularly Rhein? Anbody that says it is useless, not accurate and unreliable is a complete fool and doesn't know the basic facts about hormone urine testing. Especially Rhein and their methods used.

 

[CubbieBlue]

Not true, Rhein is NOT required. Just because they handed you a container on the way out of the door and YOU accepted it without question, tells me you didn't say, ummm...that is OK, but you can just call my labs into Quest/Labcorp, or whoever your insurance covers...and make them do it that way. They have never questioned and not sent in labs I have requested them to do.

Do you think Urine testing is useless? Particularly Rhein? Anbody that says it is useless, not accurate and unreliable is a complete fool and doesn't know the basic facts about hormone urine testing. Especially Rhein and their methods used.

Explain this please. Do you understand how the metabolites of testosterone are excreted into urine?

 

[hardasnails1973]

When dealing with complex hormon problem a dr is going want all diagnostic tools at his disposal to help to isolate the issue and to have some evidence to explain how you are feeling. We just run the 24 hour teosteorne urine and DHEA test from quest and labcorp to see if this may help shed some light on things that blood test may not be showing. It has really started to shed some light on some cases that have still had lingering issue despite being blood perfect.. So we corresponded the symptoms to the urinary levels and bumped up their doages a bit if need to to see if it will alleviate the symptoms.

 

[mqsymth]

Well as a one time patient of Crisler I can tell you Crisler tells you directly that he wants you to take the Rhein 24 urine test and hands you a Rhein box with containers and instructions on what to do and where to send it. There is no choice. if you don't wish to take the test you will not be his patient. I have no knowledge of whether the test provides helpful information or not as opposed to blood labs. My objection to Crisler and the test is that Crisler declined to answer my questions about the results or explain what the various results meant.

It's immature to call someone a fool if they don't agree with you and then provide no evidence to back up your statement. Do you expect readers to believe you by calling them names?...absurb

Not true, Rhein is NOT required. Just because they handed you a container on the way out of the door and YOU accepted it without question, tells me you didn't say, ummm...that is OK, but you can just call my labs into Quest/Labcorp, or whoever your insurance covers...and make them do it that way. They have never questioned and not sent in labs I have requested them to do.

Do you think Urine testing is useless? Particularly Rhein? Anbody that says it is useless, not accurate and unreliable is a complete fool and doesn't know the basic facts about hormone urine testing. Especially Rhein and their methods used.

 

[Michael Scally MD]

Well as a one time patient of Crisler I can tell you Crisler tells you directly that he wants you to take the Rhein 24 urine test and hands you a Rhein box with containers and instructions on what to do and where to send it. There is no choice. if you don't wish to take the test you will not be his patient.

It's immature to call someone a fool if they don't agree with you and then provide no evidence to back up your statement. Do you expect readers to believe you by calling them names?...absurb

myqsmith. I am a little busy with projects, but wanted to post here that you were spot on to be wary. The 24-hour urine test is a scam, plain and simple. Posters want proof that this is so, but it is their burden to show evidence. For the record, as I said in the thread on 24-hour urine, there is NOT a single publication in support for this testing in TRT. If you winder why, don't. It is an idiotic idea. Those who believe in this have no idea about science. Do not waste time trying to convince those that drink the Kool-Aid!

 

[Michael Scally MD]

dr. shippen had me do a 24hr URINE... are you saying hes wrong?

What was the 24-hour urine for? If for Cushing's Disease, the answer is no (and other disorders). If for TRT, the answer is a BIG YES!

 

[Bulldog]

Well as a one time patient of Crisler I can tell you Crisler tells you directly that he wants you to take the Rhein 24 urine test and hands you a Rhein box with containers and instructions on what to do and where to send it. There is no choice. if you don't wish to take the test you will not be his patient. I have no knowledge of whether the test provides helpful information or not as opposed to blood labs. My objection to Crisler and the test is that Crisler declined to answer my questions about the results or explain what the various results meant.

It's immature to call someone a fool if they don't agree with you and then provide no evidence to back up your statement. Do you expect readers to believe you by calling them names?...absurb

Dude, that is complete bullshit. I am a patient of Dr. John's and I have NEVER taken a 24 hour urine test. I just told him my insurance would not cover it and I wanted to use blood labs only. His reply? "OK, no problem".

 

[Bulldog]

Well as a one time patient of Crisler I can tell you Crisler tells you directly that he wants you to take the Rhein 24 urine test and hands you a Rhein box with containers and instructions on what to do and where to send it. There is no choice. if you don't wish to take the test you will not be his patient. I have no knowledge of whether the test provides helpful information or not as opposed to blood labs. My objection to Crisler and the test is that Crisler declined to answer my questions about the results or explain what the various results meant.
It's immature to call someone a fool if they don't agree with you and then provide no evidence to back up your statement. Do you expect readers to believe you by calling them names?...absurb

You are a patient. He is not required to teach you what the labs mean. If you want to learn what the labs mean then you need to do your own research or go to medical school.

 

[HeadDoc]

Dude, that is complete bullshit. I am a patient of Dr. John's and I have NEVER taken a 24 hour urine test. I just told him my insurance would not cover it and I wanted to use blood labs only. His reply? "OK, no problem".

thanks for posting that. The beat down on Dr. John here or Dr. Scally at ATM serves little purpose. Each of these guys has helped allot of men. Both have helped men who suffer or suffered problems w. steroid abuse. Both are good advocates of men's health and TRT, HRT as indicated. But let the music play on...........

 

[TheOldFart]

thanks for posting that. The beat down on Dr. John here or Dr. Scally at ATM serves little purpose. Each of these guys has helped allot of men. Both have helped men who suffer or suffered problems w. steroid abuse. Both are good advocates of men's health and TRT, HRT as indicated. But let the music play on...........

Very true. However, it seems to me that 2 of the worst offenders are the 2 doctors themselves. Pretty sad in my opinion.

 

[sako]

thanks for posting that. The beat down on Dr. John here or Dr. Scally at ATM serves little purpose. Each of these guys has helped allot of men. Both have helped men who suffer or suffered problems w. steroid abuse. Both are good advocates of men's health and TRT, HRT as indicated. But let the music play on...........

The ironic thing is that the little war between the two is a microcosm of the medical world and the number one thing holding medicine back; EGO.

 

[techlogik]

Well as a one time patient of Crisler I can tell you Crisler tells you directly that he wants you to take the Rhein 24 urine test and hands you a Rhein box with containers and instructions on what to do and where to send it. There is no choice. if you don't wish to take the test you will not be his patient. I have no knowledge of whether the test provides helpful information or not as opposed to blood labs. My objection to Crisler and the test is that Crisler declined to answer my questions about the results or explain what the various results meant.

It's immature to call someone a fool if they don't agree with you and then provide no evidence to back up your statement. Do you expect readers to believe you by calling them names?...absurb

Urine testing for hormones is accurate, particularly advanced methods used for detecting hormones. I don't have time to do something over again that you can easily do yourself.

Maybe you can contact the UCI and ask about the 100% urine testing they use for detection of drugs and their labs.

But why believe proven methods and facts that are right in front of your eyes to find on the internet.

 

[techlogik]

Explain this please. Do you understand how the metabolites of testosterone are excreted into urine?

Explain what? Go do the reading yourself.

Are you denying or insinuating that testosterone is (not) accurately detected in the urine?

 

[Tyler81]

The ironic thing is that the little war between the two is a microcosm of the medical world and the number one thing holding medicine back; EGO.

Yup i agree.

If Crisler didn't have such a big ego, he would probably be a better doctor. His massive ego clouds his judgement and common sense.

 

[CubbieBlue]

Explain what? Go do the reading yourself.

Are you denying or insinuating that testosterone is (not) accurately detected in the urine?

Yes, I am questioning that. Urine testing detects metabolites of testosterone, and I do not understand the specifics behind that. I was hoping you could help explain that, or point out some credible sources (as I cannot find any that definitively point either way). But if you want to be a dick about it then whatever.

 

[techlogik]

Yes, I am questioning that. Urine testing detects metabolites of testosterone, and I do not understand the specifics behind that. I was hoping you could help explain that, or point out some credible sources (as I cannot find any that definitively point either way). But if you want to be a dick about it then whatever.

Dude, I asked if you were serious. So many people are idiots on the forum and I thought you were coming off that way...sorry for that.

The way testosterone metabolites in the urine has been well known for 70+years.

Here is a brief pubmed summary, the full article is probably pretty good, but I haven't read it. The article also talks about isotope weighting, which is the method they are using now with urine tests to detect exegenous testosterone for sports, like cycling. It is how they caught Landis originally, not only was it really high the metabolite level in his urine compared to an earlier test, but the isotope weighting was consistent with exogenous testosterone due to the methods/delivery of it that is different from the baseline isotope weighting established for him.

Urinary analysis of four testosterone metabolites ... [J Anal Toxicol. 2004] - PubMed result

There are 4 well known metabolites of testosterone in the urine. Rhein uses the very popular GC/MS method for profiling hormones in urine. LC/MS/MS is becoming more popular and respected for testing by some labs. None is perfect. But the testing of urine is well known and has been around for a very long time.

Just do a search on the 4 main metabolites in the urine of testosterone and do some reading.

Although some think the UCI is corrupt and don't want to use the best method, they primarily use urine testing for doping/drug testing. It is the most cost effective and the methods are getting better for reliable testing and baselining. Of course, you need to catch somebody doing a blood transfusion today to really get them. Then again, having 50 people running around trying to collect urine/blood and control the samples is a nightmare I can only imagine and extremely expensive.

But I digress regarding the topic at hand, which is how testosterone metabolizes in the urine.

Why some people claim the levels and detection is bogus is beyond me and just ignorant against all medical and scientific facts/evidence.

 

[Millard]

But I digress regarding the topic at hand, which is how testosterone metabolizes in the urine.

Why some people claim the levels and detection is bogus is beyond me and just ignorant against all medical and scientific facts/evidence.

But I think urine testing for anti-doping purposes is a little different than urine testing for TRT purposes.

At any rate, the scientific evidence shows that some of these doping detection tests involving metabolites have their own problems with false positives, false negatives:

https://thinksteroids.com/news/testosterone-epitestosterone-ratio-test-false-negatives-and-false-positives/

Common Doping Test for Athletes is Unfair (and Racist) - MESO-Rx

The testosterone:epitestosterone ratio (T:E ratio) test is a commonly used test designed to catch athletes who artificially manipulate their testosterone

thinksteroids.com

 

[CubbieBlue]

Dude, I asked if you were serious. So many people are idiots on the forum and I thought you were coming off that way...sorry for that.

The way testosterone metabolites in the urine has been well known for 70+years.

Here is a brief pubmed summary, the full article is probably pretty good, but I haven't read it. The article also talks about isotope weighting, which is the method they are using now with urine tests to detect exegenous testosterone for sports, like cycling. It is how they caught Landis originally, not only was it really high the metabolite level in his urine compared to an earlier test, but the isotope weighting was consistent with exogenous testosterone due to the methods/delivery of it that is different from the baseline isotope weighting established for him.

Urinary analysis of four testosterone metabolites ... [J Anal Toxicol. 2004] - PubMed result

There are 4 well known metabolites of testosterone in the urine. Rhein uses the very popular GC/MS method for profiling hormones in urine. LC/MS/MS is becoming more popular and respected for testing by some labs. None is perfect. But the testing of urine is well known and has been around for a very long time.

Just do a search on the 4 main metabolites in the urine of testosterone and do some reading.

Although some think the UCI is corrupt and don't want to use the best method, they primarily use urine testing for doping/drug testing. It is the most cost effective and the methods are getting better for reliable testing and baselining. Of course, you need to catch somebody doing a blood transfusion today to really get them. Then again, having 50 people running around trying to collect urine/blood and control the samples is a nightmare I can only imagine and extremely expensive.

But I digress regarding the topic at hand, which is how testosterone metabolizes in the urine.

Why some people claim the levels and detection is bogus is beyond me and just ignorant against all medical and scientific facts/evidence.

This is just for a T/E ratio based on a small number of metabolites. That is not the full number of metabolites that T produces in the urine. I want to know if testosterone levels can be accurately assessed via 24 hour urine sample, and why it is better to test it this way than via serum.