Got a letter from my Endocrinologist addressing SWALES TRT Protocol

[SWALE-Follower]

Well.. To update everyone. I am 38 years old. I was diagnosed with low testosterone a while back (150) and consquently was put on Androgel at 7.5mg/day by my GP; which brought my levels up to 500 range. After reading Swale's TRT protocol, I decided to seek an endocrinologist hoping that he'll assist me in following Swale's teachings. Upon my visit I suggested using HCG along with my AndroGel and gave a copy of Swale's article (TRT: A Recipe for Success). The doctor refused the treatment options. Today, I recieved a letter from my Endocrinologist... Here it is:

Dear Mr. X

It was a pleasure to meet you recently in the Duke Endocrinology Clinic. As we discussed that day, it is likely that your hypogonadal or low testosterone state was due to your previous anabolic steroid use. With regards to the information you sent to me via Dr. Crisler, I dont feel that the use of HCG injections on a rare intermittent basis is likely to provide benefit in regards to prevention of shrinking or atrophy of the testicles. Dr. Crislers work is no where in the medical literature that I can find. In addition, the proposed procedures dont make intuitive physiologic sense to me.

There is however a publication from last month looking at the use of low doses of HCG three times weekly in men who take testosterone and it appears that these low doses are able to maintain normal concentrations of testosterone within the testes. Presumably, then, this may well be contributing to normal sperm production and testicular size. These studies are preliminary and still have ways to go, but the data is encouraging. Again, this is quite different from what Dr. Crisler is proposing.

Given this, you have two choices for your current management of testosterone repletion. Either you can continue with the testosterone gel as before or you could give consideration to three times weekly subcutaneous HCG injections. I would not use both based on the available data. If you are interested in pursuing the injection therapy, particularly if you and your wife have an interest in future fertility, I could set you up for teaching and a prescription to start therapy. If you are not interested in this and would like to continue with the testosterone gel therapy as before, you may follow up with Dr. Jones. I have sent a copy of my office note to her to guide her in regards to your continued management.

Please let me know if you have any questions.

Sincerely,

Thomas J. Weber, M. D.
Assistant Professor of Medicine
Division of Endocrinology, Metabolism and Nutrition
Duke University medical Center.


Given my dissapointement with Dr. Weber, I pursued another option and was able to find a doctor via the web site for Anti Aging doctors that swale wrote about before. I was able to find a doctor who actually knows about Dr. Crisler and his protocol and agreed to treat me accrodingly.

Today, I am on AndroGel, HCG, and Arimidex. I am due for a follow up within six months for blood work to ensure things are going well.

Although I have washed my hands off the "big-shot Duke" Endocrinologist and my GP, I would love to be able to prove him wrong. But, I know he won't even listen to what I have to say.

 

[HeadDoc]

send him a picture of your pregnant wife and your balls.----along with a copy of the the protocol of course.

 

[earthdog]

At least he took the time to read and understand and research Dr. Crisler's paper. That's more than a lot of guys here got from their doctors. Dr. Crisler's work is not likely to appear anywhere in the literature until someone does a double blind study to prove its effectiveness, and who is going to fund that? So you did the right thing, and that was to find a doc that would work with you. Keep us posted on how things go.

 

[SWALE-Follower]

At least he took the time to read and understand and research Dr. Crisler's paper.

Well... I wouldn't say that he understood it... If he did, he wouldn't say "HCG injections on a rare intermittent basis"... Anyone who read Dr. Crisler's paper would know that there's no "rare intermittent" HCG application but "often regular" instead!!

Then Dr. Weber goes to contradict himself in the second paragraph by displaying his find of the latest hcg protocol that looks exactly like Dr. Crisler's.... and even then, Weber still doesn't agree with it.... You go figure!!!!

 

[SWALE]

Yes, let's give Dr. Weber credit for at least doing some research.

He simply does not understand what the HCG Protocol is about. Saying it makes no "intuitive physiological sense" proves this.

Twice weekly shots is not "rare Intermittent" use. In fact, that is how most doctors use HCG in TRT, and is specifically what I am trying to avoid.

The only place you will find my work published is in the American Academy of Anti-Aging Medicine's 2004/5 Anti-Aging Clinical Protocols manual. Conducting formal studies is a HUGE undertaking, and I simply do not have the time nor the means to undergo such projects at this time.

You have already noted that a three times per week protocol is called "encouraging" by him. This shows me he simply did not really read my paper. It is not hard to understand, really.

The paper he mentions demonstrates that 250IU of HCG per day every other day produces ITT (Intra-Testicular Testosterone) levels at the upper quartile of normal range. What better measure of its efficacy could there possibly be? This is the dosing I have been recommending for quite some time now. I am glad someone took the expense and time to prove it--although my patients already have. LOL.

I have personally taught this protocol to literally hundreds of doctors now, and none have found flaw with it. And the top Anti-Aging Medicine (IMPO) physician in the country has now adopted my protocol, and describes it in his lectures, with full credit for same. And that is pretty satisfying for me, as you would imagine.

The simple fact is that I will never be a big mucky-muck at a huge university or powerful foundation. I will never have a long list of letters after my name. But what WILL be true is that thousands and thousands of men, all over the world, will be happier and healthier due to my efforts. That is enough for me.

As my name grows within the world of conventional medicine, perhaps one day Dr. Weber will recall "ya, I heard something about that guy a long time ago". LOL.

Actually, I draw great inspiration from a post like this. Thank you for taking the time, SWALE-follower, as well as the rest of you gentlemen who have responded.

I am glad you have successfully located a physician willing to administer cutting-edge TRT.

 

[SWALE]

HeadDoc--You are a true iconoclast at heart!

 

[SWALE-Follower]

You are absolutely correct SWALE... I don't believe Dr. Weber has truly understood your paper. I'm going to leave him alone and I'm happy to finally have found another doctor who knows about your work and willing to treat me according to your protocol. Thank you for all your help and support SWALE.

 

[Millard]

The response surprised me. I would have thought TRT would have progressed a little more rapidly in academia/med schools. But apparently not.

Maybe, we've been fortunate enough to have SWALE's expertise here for so long that we assume his protocols would have wider acceptance. The rationale and support behind the protocol are sound.

But what do I know? I'm not a Duke Univ med school professor!

SWALE, perhaps you could post something for members of the TRT forum to print out that shows which prominent doctors, organizations have accepted and/or adopted your protocols as well as some of your lectures at top anti-aging conferences?

Regrettably, many doctors out there will not be swayed by the logical rationale for tRT presented in your "recipe for success" whether out of ignorance or stubbornness. But if they are presented with some additional information about who you are, the organizatoins that adopt your protocols, and the major conferences which invite you to lecture before them, then this will get their attention.

Now, I for one absolutely hate it when people need "credentials" to help them determine the validity of a protocol or idea. But admittedly, many people in society, including MDs, are like that.

What do you think?

 

[mranak]

...and was able to find a doctor via the web site for Anti Aging doctors that swale wrote about before. I was able to find a doctor who actually knows about Dr. Crisler and his protocol and agreed to treat me accrodingly.

Do you mind my asking what doctor this is?

 

[mranak]

The paper he mentions demonstrates that 250IU of HCG per day every other day produces ITT (Intra-Testicular Testosterone) levels at the upper quartile of normal range.

How did they measure this? Maybe I shouldn't ask? ouch.

I'm been meaning to ask about this issue for a few months, but I never finished doing my own research first. I read about some type of blood barrier within or near the testes and I speculated that perhaps exogenous testosterone could not pass this barrier. Testosterone is required for the leydig cells to make sperm, so I reasoned that the reason hCG prevents testicular atrophy has more to do with the fact that there is ultimately testosterone in the environment of the leydig cells.

 

[forex]

Yes, let's give Dr. Weber credit for at least doing some research.

He simply does not understand what the HCG Protocol is about. Saying it makes no "intuitive physiological sense" proves this.

Twice weekly shots is not "rare Intermittent" use. In fact, that is how most doctors use HCG in TRT, and is specifically what I am trying to avoid.

The only place you will find my work published is in the American Academy of Anti-Aging Medicine's 2004/5 Anti-Aging Clinical Protocols manual. Conducting formal studies is a HUGE undertaking, and I simply do not have the time nor the means to undergo such projects at this time.

You have already noted that a three times per week protocol is called "encouraging" by him. This shows me he simply did not really read my paper. It is not hard to understand, really.

The paper he mentions demonstrates that 250IU of HCG per day every other day produces ITT (Intra-Testicular Testosterone) levels at the upper quartile of normal range. What better measure of its efficacy could there possibly be? This is the dosing I have been recommending for quite some time now. I am glad someone took the expense and time to prove it--although my patients already have. LOL.

I have personally taught this protocol to literally hundreds of doctors now, and none have found flaw with it. And the top Anti-Aging Medicine (IMPO) physician in the country has now adopted my protocol, and describes it in his lectures, with full credit for same. And that is pretty satisfying for me, as you would imagine.

The simple fact is that I will never be a big mucky-muck at a huge university or powerful foundation. I will never have a long list of letters after my name. But what WILL be true is that thousands and thousands of men, all over the world, will be happier and healthier due to my efforts. That is enough for me.

As my name grows within the world of conventional medicine, perhaps one day Dr. Weber will recall "ya, I heard something about that guy a long time ago". LOL.

Actually, I draw great inspiration from a post like this. Thank you for taking the time, SWALE-follower, as well as the rest of you gentlemen who have responded.

I am glad you have successfully located a physician willing to administer cutting-edge TRT.

Swale-
could you please provide a link to your work published is in the American Academy of Anti-Aging Medicine's 2004/5 Anti-Aging Clinical Protocols manual? I would like to show it top my doc in order to get him aquianted with your HCH protocals. (I already sent him your HRT manual).
Thank you,
Ed

 

[forex]

Check out this chart regarding bioidenticals, it says cyp is NOT bioidentical. Please advise, I am confused:

http://www.ourgyn.com/bioidenticalchart.html

 

[Millard]

Swale-
could you please provide a link to your work published is in the American Academy of Anti-Aging Medicine's 2004/5 Anti-Aging Clinical Protocols manual? I would like to show it top my doc in order to get him aquianted with your HCH protocals. (I already sent him your HRT manual).
Thank you,
Ed

I believe it's his "recipe for success" that is a sticky in this forum. The protocol manual itself is a couple hundred bucks.

 

[SWALE]

Forex--You ask a great question.

By some definitions, unless a hormone is actually extracted from humans, it could not be considered "bio-identical. But all must be manufactured in some manner, or there would never be enough available to treat people. So they are made, following selective breeding and molecular engineering, from plants. But the molecule is exactly the same as the testosterone in your body.

BTW, I do not consider adding a cypionate ester, in order to improve pharmacokinetics, deviating from bioidentical.

It is a completely different matter, however, to use the estrogen from horses. That is not the same as human estrogen. And at the toxic dosages usually employed for female HRT, you get the myriad of ill effects documented in the Women's Health Initiative.

The manual you request contains the same TRT: A Recipe for Success I posted here. But it may be purchased through A4M:

www.worldhealth.net

Mranak--Yup, how they got (all those) samples is just how you would think!

 

[Millard]

Check out this chart regarding bioidenticals, it says cyp is NOT bioidentical. Please advise, I am confused:

http://www.ourgyn.com/bioidenticalchart.html

For all practical purposes, it is bio-identical. Your body can not distinguish it from "natural" endogenous testosterone once it is freed into the bloodstream.

Technically, it can be argued that it is not bio-identical because (1) it is synthetic and (2) the testosterone molecule is esterified to enhance half life.

Natural is not always better than synthetic. I'd always rather have testosterone synthetically created in a lab rather than that derived from yams!

Testosterone esters allow slow release of T into the bloodstream over a specified amount of time.

I wouldn't advise anyone inject straight, natural, bio-identical T derived from yams into your body as a form of TRT

 

[cpeil2]

Natural is not always better than synthetic. I'd always rather have testosterone synthetically created in a lab rather than that derived from yams!

Isn't pretty much all of it derived from yams or soy beans? The base molecule used in the synthesis of most steroid hormones, diosgenin, usually comes from mexican yams or soy beans.

 

[forex]

Thanks for clarifying this issue for me Swale and admin I believe I could feel comfortable with cyp after my new understanding.

Alas 1 more question regarding this topic: Are there any long term negative side effects known from using cyp at your prescribed TRT dosing, Swale? (ie cancer, heart attacks...)

Thank you.
Ed

 

[testiculies]

taking matters into my own hands(forget endos)

well since the endo did not want to include hcg into my hrt i chated with a fellow i know and he was in the same boat and did some research and this is what protocol looks like .100mg test enthante a week,gives hcg 250iu 2 days before his injections.he also incorporates clomid and proviron which he altenates every other week ie .test enthanate,hcg, clomid,next week test enthante, hcg, proviron .he states this method is supperb in in keeping the boys happy and very heathy sex drive primarily due to the proviron.so i think i may give this a try and see what happens,unless any one see's something wrong with this protocol.cheers

 

[SWALE]

APPROPRIATE TRT REDUCES the risks of cancer, cardiovascular disease, osteoporosis, depression, dementia (including Alzheimer's), diabetes and ED--that we know of so far.

 

[Matt Muscle]

well since the endo did not want to include hcg into my hrt i chated with a fellow i know and he was in the same boat and did some research and this is what protocol looks like .100mg test enthante a week,gives hcg 250iu 2 days before his injections.he also incorporates clomid and proviron which he altenates every other week ie .test enthanate,hcg, clomid,next week test enthante, hcg, proviron .he states this method is supperb in in keeping the boys happy and very heathy sex drive primarily due to the proviron.so i think i may give this a try and see what happens,unless any one see's something wrong with this protocol.cheers

Hey Mate... let me know if you try this protocol with the clomid and Proviron... how much clomid/prov is he taking per day?
I am very interested to see how you feel etc.
thanks.