Effect of T on Blood work

[Tryptomainiac]

After compinig about ED, loss of libido and lack of penile sensititivty, my Uro gave me a serum T test which came back at 343 w/ normal being 1080-400. That, and a blood glucose, were the only test my Uro ran, based on the results he had his nurse started me on 5g Androgel daily. I was told to call back if it seemed like it worked which was ok since his office is 2 1/2 hrs away. I called back, assuming it would be for a follow up appointment, but instead I was told they were going to mail me a prescription for the androgel with 11 refills. Thats it, no follow up, no PSA, I dont even have an appointment to see my Uro next year.

By appealing to her competitive nature (my uro is from the city), Ive been able to convince my GP to run some blood work that I feel the Uro should have done. She ordered a total T, FSH, LH, Prolactin, E2, TSH, PSA and CBC. I asked if she would order a thyroid panel, but she said it wouldnt tell her anything different than the TSH. She said the same thing when I asked about testing for Free T. I also asked if she would consider testing for DHT and Cortisol, she said no and suggested we might be better off forgetting all the testing. I know a hint when I hear one, so I shut up.

Since Ive been using androgel for the past 3 wks, I asked her if I should stop the androgel before the tests and she said that with the exception of the total T it wouldnt make a difference! I know she is wrong, but I decided not to push it since she made it perfectly clear that she didnt want to run any of them (with the exception of the TSH and CBC) in the first place and I was already skating on thin ice.

My question is what will the tests tell with no baselines other than serum T? My concerns are two-fold. First, will they help in assessing my TRT therapy. Second, and more important to my mind, will they point to the cause of my low T helping to route out anything more serious?

Any advice, references, pointers, etc., will be truly appreciated.

 

[dj75]

Your uro only ran one test? One low test does not prove anything other than you need to take another test to make sure it is low........
how long have you had ED?
How old are you?

 

[smitty4]

Not getting baselines for the tests you mention is bad enough, but giving someone a script for Androgel without giving them a PSA first doesn't make any sense to me at all. Sort of sounds like playing Russian Roulette.

 

[buck]

The first Dr. I went to was a Uro. Just on the symptoms I told him he gave me a script for Androgel. Then tested me on the follow up. I had previous tests showing I was low be he had not seen those tests.

 

[SWALE]

I do wish you could get under the care of someone who knows how to do this.

The fellas have made some very good points here.

 

[Tryptomainiac]

I'm 38yrs old, and I've had Ed for 4 or 5 yrs. My cheif complaint was lose of sensitivity, in fact I didn't really know I had ED until I started the androgel. I always thought that I was hard enough to get the job done. My lose of sensitivity just made it so it was unlikely I would ejaculate. I thought my lose of libido was just because I had given up trying to get satisfaction because of my low chance of reaching climax.

The lose of sensitivity has been going on for about 15yrs, but it has only been in the past 4-5yrs that I haven't been able to feel enough to routinely ejaculate. I think that was also part of why I didn't pick up on the ED, I didn't expect to climax so as long as my girlfriend did I figured everything was working in that department.

I've read the AACE guidelines and John Crisler's, D.O., "Recipe for Success", so I didn't think that my Drs. were doing it right, but I live in a very rural under served area so there isn't much choice. Up until 30yrs ago the only Drs. most folks saw were the traveling clinic Drs. at their twice monthly visits. Things have changed dramatically since I was a kid, but compaired to most we have limited choices. Part of the reason my Uro gave me the yr long Rx was to save me from having to make long trips to the "city" for new prescriptions and to pick up the androgel. The way he set it up I can have everything mail ordered.

I did bring the AACE guidelines and "recipe for success" with me to my GP, she put them in my file without looking at what they were. Then, at the end of my visit she took them out of my file and handed them back to me and said "Why don't you hold on to these for me for now"

That's why I'm trying to get an idea of what good the tests are w/o baselines and done on the 3rd week of androgel. I don't have much faith that she will do much with the results, but I will get them as well and I need to know what they mean so I can decide if I need to travel out of state to Boston for evaluation/treatment. This will be a great expense, not covered by insurance, and will mean taking off from work and staying in hotels, so it's not something I can do lightly.

 

[SWALE]

She obviously has decided she does not care to administer appropriate TRT. And that is her choice. I think it probably is preferable to providing innappropriate TRT.

If you are going to travel, come to Lansing, MI. We'll get you taken care of at "The Man Cave".

 

[Tryptomainiac]

If you are going to travel, come to Lansing, MI. We'll get you taken care of at "The Man Cave".

I spent my first 3 months in utero in MI, so it might be like returning home. Can I get a rough estimate of how much time would I have to spend in MI to do things right and # of trips I'd need to make?

 

[SWALE]

Yes, Utero is a fairly small town, but it is quite nice there.

I generally spend about an hour-and-a-half with each new patient.

Once you have been here once, that can be enough. Although you would always be welcome, of course.

I have guys who fly in from the West Coast, see me, and are back home that same day. My Brother-in-Law owns a taxi service, so he has a driver right there waiting when my patients get off the plane. And Capitol City Airport is so easy to get in and out of.

 

[DavidZ]

Yes, Utero is a fairly small town, but it is quite nice there.

You live in Utero? Isn't that kinda Freudian?

Sorry, I couldn't resist.

BTW, I did a Mapquest search and they don't think Utero, MI exists.

 

[Tryptomainiac]

You live in Utero? Isn't that kinda Freudian?

Sorry, I couldn't resist.

BTW, I did a Mapquest search and they don't think Utero, MI exists.

My understanding is that Utero, MI was relocated to Maine some 38 yrs ago.

I'd like to thank everyone for all the thoughts/comments. I'm going to wait until the blood work comes in and see what my GP does with it. If she doesn't want / can't do proper TRT, then I'll be taking a trip to MI. I'd rather do that than take a cr*p shoot with finding a qualified Dr. in Boston. SWALE, if it comes to me traveling to Lansing how long should I be off the Androgel before coming?

 

[SWALE]

Just so I understand you correctly, IF you are wishing to maintain TRT, then I want you on the Androgel when I see you. Patient should take their Androgel the morning of the tests, in fact. Othewise, you change EVERYTHING. If you are wondering what your baseline hormone levels are, then three weeks of abstinence should be enough.

 

[mranak]

If she doesn't want / can't do proper TRT, then I'll be taking a trip to MI.

I think that fact that she didn't run a free testosterone or bioavialable testosterone assay is evidence enough that she has no clue about how to appropriately do TRT. But, at least you will have some labwork. Get a copy of the lab report.

Yes, physicians that understand appropriate TRT are unfortunately a rare item. You will save yourself a lot of trouble and get the best treatment if you see SWALE.