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Testosterone treatments - educate me. (1 Viewer)
- Thread starter matuski
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johnnycakes
Footballguy
Just got back from my MRI. In today's mail was a bill for all the lab work. Must be my deductible on health insurance, but I paid $407 just now for all the lab work.
johnnycakes
Footballguy
Got the results of my MRI back.
AAABatteries
Footballguy
Wei Yang - that’s an unfortunate name.
Terminalxylem
Footballguy
Didn’t see this response. With those lab values, there was probably no need for an MRI.
While your primary doctor will likely give you what you’re looking for, I’d still consider asking for asking for endocrinology referral, as they’re more in tune with the nuances of testosterone supplementation. While a little technical, Here is their position statement on low T with aging.
johnnycakes
Footballguy
Well I had my video visit with my PCP this morning to go over "the next step" in treating my hypogonadism. This PCP does a lot of talking but so much of it is technical and over my head. She went through a bunch of reasons why testosterone replacement therapy (TRT) isn't such a great idea. I wasn't sure where she was going with the visit.... at one point she suggested I get a referral to a urologist. I pushed back on that, saying I didn't see the point and that I would like to proceed with TRT. At that point, she agreed to prescribe me Androgel. So I'll start with Androgel in the next day or two. Then I have to go back in a month for more blood work to see where my testosterone level stands.
Harumph. Now I go to the Androgel website, and what do I read, but a disclaimer, "It is not known if AndroGel is safe or effective to treat men who have low testosterone due to aging." Mine is definitely due to aging. So I guess I'll hope for the best.
I'm thinking I perhaps should have taken @Terminalxylem's advice and asked for a referral to an endocrinologist. I didn't because I saw that as one more delay in getting me some kind of treatment. But if the Androgel doesn't do the trick and the PCP balks at testosterone injections, I think I will ask for that referral at that point.
Oh yeah.... and remember that damned MRI I had to go for? Well, I got a bill for that. $1,193.12. That's what I have to pay after insurance contributed their $750 or thereabouts. And I already paid a $50 copay the day of the MRI. Combined with what I had to pay for the lab visits, I figure I've invested about $1,600 out-of-pocket in order to go through my PCP for TRT.
Harumph. Now I go to the Androgel website, and what do I read, but a disclaimer, "It is not known if AndroGel is safe or effective to treat men who have low testosterone due to aging." Mine is definitely due to aging. So I guess I'll hope for the best.
I'm thinking I perhaps should have taken @Terminalxylem's advice and asked for a referral to an endocrinologist. I didn't because I saw that as one more delay in getting me some kind of treatment. But if the Androgel doesn't do the trick and the PCP balks at testosterone injections, I think I will ask for that referral at that point.
Oh yeah.... and remember that damned MRI I had to go for? Well, I got a bill for that. $1,193.12. That's what I have to pay after insurance contributed their $750 or thereabouts. And I already paid a $50 copay the day of the MRI. Combined with what I had to pay for the lab visits, I figure I've invested about $1,600 out-of-pocket in order to go through my PCP for TRT.
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notoriousbill
Footballguy
I tried Androgel and Natesto. Hated Natesto (nasal application). Both were very expensive. They both increased my testosterone levels as well. I opted for injection and have been doing them for over hte past year with no complications or side effects. I get a shot once every 3 weeks and it keeps my levels in the normal range. I notice my mood and "outlook" is improved as well as the obvious benefits.
I hope this helps and good luck!
johnnycakes
Footballguy
If you tried Androgel and it increased your testosterone level.... how did you make the switch to injection? How did that convo go with your doctor?
notoriousbill
Footballguy
I told him I wanted injections and did not like the application of a gel daily. My Dr was really open to my concerns. Also, the cost for the injections are a fraction of the cost for the topical/nasal treatments.
If you tried Androgel and it increased your testosterone level.... how did you make the switch to injection? How did that convo go with your doctor?
johnnycakes
Footballguy
Thanks for the ideas. I think I will wait and see how the Androgel goes. I'm not really excited about applying the gel on a daily basis, either. But I get the feeling this PCP is definitely gunshy about prescribing injections.
notoriousbill
Footballguy
Phil Elliott
Footballguy
I do a testosterone cream formulated by local pharmacy. Use to use Andogel, but insurance decreased coverage a lot. Used another brand for a short time. Urologist was getting so many demands to justify the treatments by insurance he said screw it and invested in the pharmacy. He will still issue prescription for Androgel or others if you want. Insurance companies have gotten tough on testosterone treatments. I use my HSA for payments.
Phil Elliott
Footballguy
You might want to go see a urologist for second opinion.
Terminalxylem
Footballguy
To be fair, both urologists and endocrinologists should be familiar with testosterone supplementation. I’d choose the latter because they’re more likely to consider ramifications of testosterone supplementation outside the geniturinary tract, and they aren’t primarily surgeons.
Either way, expect a lot of disclaimers and be wary of anyone who gives into your demands without some push back. Testosterone is easy to misuse/abuse, both by patients and prescribing doctors.
johnnycakes
Footballguy
Well it took until today to get the prescription filled through my pharmacy. My insurance doesn't cover testosterone gel, unless it is prescribed for certain medical reasons, none of which apply to me. So the cost for a month's supply of testosterone gel is $377.15. That's for 1% gel, 50mg per 5 grams. I have a feeling I will be speaking to my PCP about the cost of going with injections. How long should it take before I begin to see results?
STEADYMOBBIN 22
Footballguy
Chadstroma
Footballguy
I was getting injections for a while when I was on a doctor supervised diet. I ended up going (long story) and getting them but the doctor explained to me when I started (and had very low levels) that losing weight and regular exercise would be the main way that the body would start producing more on it's own and doing this in the meantime was to assist.
I see this comment was from 7 years ago... so I am curious if you followed those studies and what they came out at to say.
Chadstroma
Footballguy
The injections I was getting at every other week was like $120ish for the month.
That didn't include the office visit cost but I was paying that anyways because I was on a doctor supervised diet.
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Chadstroma
Footballguy
Are there any pills etc that help your body produce more testosterone versus getting actual testosterone shots/gel, etc?
johnnycakes
Footballguy
There are many supplements that claim to help with Low-T but I think those claims are by and large bogus,.
Chadstroma
Footballguy
Yea... exactly. I don't trust the take these pills commercial crap.
But was wondering of there was like an herbal supplement or something that actually does help.
johnnycakes
Footballguy
Well, the above are the results of my "before" blood tests. I've been using the testosterone 1% gel for a month now and the updated results are as follows:
SEX HORMONE BINDING GLOBULIN 7.6 nmol/L 21.6 - 113.1 nmol/L L
TESTOSTERONE TOTAL 1,013.6 ng/dL 100.0 - 780.0 ng/dL H
TESTOSTERONE, BIOAVAIL, MALE >20 890.0 ng/dL 130.0 - 680.0 ng/dL H
TESTOSTERONE FREE 388 pg/mL 47 - 244 pg/mL H
So there is no doubt the gel is working. I took that second blood test around 10:15am after applying the gel around 8:00am. I wonder if that might have spiked the result.
notoriousbill
Footballguy
Did your Dr recommend applying it right before a test? Just curious because if going through insurance, they may have him reduce the amount or decline. I do injections and forgot about an appointment for bloodwork right after I had my 3 week injection and my insurance cancelled due to high levels at the time of blood test.johnnycakes said:
Glad to see it is working. Do you "feel" better? My whole attitude, level of depression etc improved dramatically after I started injections.
johnnycakes
Footballguy
The doctor didn't say anything about the timing of gel application with respect to blood draw. I go for another blood draw this Saturday. I think I'll not apply the gel before this test. But yeah, I do feel a lot better with the testosterone levels elevated with this medication.
flapgreen
Footballguy
They love making that money from imaging. Not nearly as much as they love your health improving.
flapgreen
Footballguy
No worse than many doctors and big pharma prey on folks. Insurance companies are no better either.
Terminalxylem
Footballguy
Oh, it’s definitely worse. A small minority of doctors are predatory, and many of them get involved with aesthetic medicine, nutraceuticals, anti-aging and medical marijuana. Low T overlaps with those pseudoscientific offshoots of conventional medicine. While it’s certainly possible to legitimately diagnose and treat hypogonadism, a bunch of providers are simply preying on the insecurities of aging men.
I’m no fan of ginormous businesses, including pharmaceuticals/medicine, as big anything can easily abuse their power. And I’d be content to eliminate the entire private insurance industry.
But none of that validates the business practices of many (not all) clinics pimping testosterone as a panacea.
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Phil Elliott
Footballguy
$100 for 90 day supply compounding pharmacy.
In Dec I went to donate blood and hemoglobin was 19+. At 20 it won't flow through the needle and they will turn you away. Hematocrit was 53. I stopped the testosterone for four months and ate a grapefruit a day for three months. Hemoglobin dropped to 14 and Hematocrit dropped to 43. Now I am using half the dose daily and getting blood tests every 6 months.
For blood tests they usually want you in by a couple of hours after applying cream.
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Terminalxylem
Footballguy
There’s a lot of bad info out there, and inappropriate testosterone prescriptions. Although these links are filled with medical jargon, you can probably get the gist of the appropriate work up of testosterone deficiency, along with the risks and benefits of supplementation.
Urology guidelines
Endocrinology guidelines
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flapgreen
Footballguy
I've worked in Healthcare for 15 years and would disagree. Just sold my home and uprooted my family and moved out of state because of how bad it's gotten. The entire field is about making money, with a few clinicians mixed in who genuinely care about their patients, TRT prescribers or otherwise. You have to be your own advocate at this point.Terminalxylem said:
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Terminalxylem
Footballguy
I agree medicine has become more business-like over time. And it certainly varies by location - I’ve known people who’ve worked in Las Vegas, San Diego and Miami who make their practices seem pretty terrible, for example.
I’ve also met some of the most honest, caring human beings in the hospital I’ve worked for nearly two decades. Sure there are a few bad apples, but nowhere near the entire field of any discipline.
But the worst are those who chase the money, and either cherry-pick insurers or refuse them altogether - a lot of so-called “men’s health” clinics fit the bill. Extensive advertising is also a red flag, as are offices that look like spas.
Just look at how much the industry has blown up over the last decade. While low testosterone had been historically under treated, there’s no way so many men need supplementation. It’s pretty obvious reading this thread it’s ripe for abuse, both by provider and patients.
STEADYMOBBIN 22
Footballguy
Injections? You doing your own? What’s your dosage? Do you know the name of what they’re prescribing you?
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flapgreen
Footballguy
Cyp. Started at 100mg 2x a week but have gotten a little acne and nipple sensitivity. Bumping it down to 80mg 2x a week. Would rather decrease dosage than take an AI. Yes, injections. Give them myself
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STEADYMOBBIN 22
Footballguy
I am not a doctor so take this for what it’s worth….
The half-life for cypionate is 8 days. I’m shocked they have you taking two in a week. That’s usually for something that only has a half-life of about four days. Maybe they’re just trying to get yours bumped up really fast but IMHO that’s totally unnecessary.
If I were you I would do one shot every five days.
Another tip is if you’re getting soreness at the injection site it’s likely because you’re aspirating. Aspirating is the correct way so you don’t hit a vein, but it also causes trauma hence the pain. once you’re more comfortable I’d recommend not aspirating, that injection site soreness is a pain in the ###, pun intended.
if the nipple soreness continues you might wanna discuss adding an estrogen blocker.
again, I am not a doctor and I do not know anything about your body/levels.
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BroncoFreak_2K3
sucker for Orange
Make sure your doc is requesting full blood workups every 2-3 months to monitor and maintain all other systems. Especially PSA levels.
Good Luck!
Good Luck!
flapgreen
Footballguy
I work in Healthcare and am fairly educated and did a lot of research on TRT leading up to it. Had considered it a few years ago but decided against it. Now in my mid 40s and thought what do I have to lose. I really do feel like a new person on it. Tons of energy. Sleep much better. I was already pretty and have always stayed in shape. This has just given me that boost of energy I've been lacking for so long.
Just completed my follow up labs last week, but I already dropped my dosage from 100mg 2x/week to 80 2x/wk. Nipple sensitivity and other symptoms almost completely gone now. Still have a little acne on my back lingering but it's also clearing up. Would prefer to drop dosage before considering any type of estrogen blocker. The fewer things I have to take the better imo. No problems at injection sites.
GoBirds
Footballguy
That’s good stuff, hope all is well buddy. The extra boost of energy is something I could use but injections sound a little scary.
flapgreen
Footballguy
That’s good stuff, hope all is well buddy. The extra boost of energy is something I could use but injections sound a little scary.
####. Meant to say "pretty fit."
GoBirds
Footballguy
flapgreen
Footballguy
GoBirds
Footballguy
flapgreen
Footballguy
Not for TRT. They have other pills you can stack with test but not just a standalone test pill
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BassNBrew
Footballguy
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