HRT clinic Appt. Wednesday

[Prsartist]

Ok, Wednesday is my appt at the HRT "specialist".
This journey over 6 years has left me frustrated and I'm not able
To compose a list of Intellegent questions to ask.
I have kept a pretty good log of all my issues (over the last 3 years)

But I'm becoming skeptical that anyone knows anything or will help at this point if they
Don't instantly recognize total T of 290 as a big problem.

Anyone have any ideas on what I should be asking them
Or what approach to take when I get there?

[PeakT]

Well, if you are just trying to ascertain if they really do know what they are talking about, you could try some of the questions that I ask the doctor's:

http://www.peaktestosterone.com/Physician_Network_Teeple

However, if you're just trying to find out if they'll treat you, then I would just ask them.  Just tell them that you've been struggling with classic low testosterone symptoms for years and tell them your testosterone readings and see what they say.  I think you'll get a pretty good feel from just that.

Now keep in mind that almost any decent doc is going to want to find out about your prostate, medical history, etc. before he/she puts you on HRT.  So that doesn't mean that they are trying to put you off necessarily but just doing their due diligence.

[Prsartist]

Thanks

I am prepared as far as testing goes, I even had my primary
Run LH, FSH, Estradol, T & FT, last week.
I have my labs from the last 6 months (which have PSA, and anything else they should need)

As I stated before my primary Dr. Did agree to treat this.
But he does not know much about HRT, and he frankly
Make me nervous as i know more than he does!  I know very little, BUT I KNOW this is a problem!

I would prefer to have someone more knowledgeable monitor this treatment
(if I can find someone??)

[Prsartist]

Excellent link!
I'm going to bring that in to the appt.

I thought I had everything covered, but I see "prolactin"
As something that needs to be monitored.
I don't know what that is/does and don't think it was on any of my
Previous labs (I'll have to check) I'm so sick of the same ole'
Testing everything and doing Nothing.....

I wish I were closer to Tx........

[PeakT]

If your prolactin is high, it can be a sign that you have a prolactinoma or other issue (which will pull down T).  Here is a little basic info:

http://www.peaktestosterone.com/Testosterone_Prolactin_Prolactinoma

You don't necessarily need prolactin constantly monitored, but imo it's not a bad idea to pull it from time to time if you can afford it just to play it safe.  (Talk to your doc about it though.)  I basically mentioned it because I have the impression that many less knowledgeable docs forget to even take a look at it.

[Prsartist]

Great!

Problems with prolactin are related to a pitituary
Tumor.....
Ive been doing research on my other tests Dr. Have run
And discovered high aldosterone and low renin...

Which can be caused by an adrenal tumor, which I know I have (very small)
Or a pit. Tumor!


 If you do the math I've got problems
With low T, adrenal hormone problems, questionable thyroid issues,
And which gland controls all these??

Pitituary!!!!  Now I'm not afraid of surgery
But going into the brain thru your nose is NOT
Something I want to even think about!

[Prsartist]

Well...
Had appt today, I just showed the dr. My last 3 Lab results and asked If he saw a problem?
He looked them over and said the magic words Ive been dying to hear
"your testosterone is way too low!".
He asked a few questions about symptoms
(morning erections, libido etc.). I have all symptoms
Of low T other than anemia, I actually have a slightly
High RBC count.
He spent a good 20 minutes asking question
And providing the exact info. I received from the forum here
He even explained why other Dr's. Often overlook
Low T...

He did order a few other tests that I didn't previously have. (SHBG & a few others)
But saw no reason to delay treatment and started me on
T injections of 100mg 1X a week.  He also has me on the Gel (not androgel)
2x a day as he felt my symptoms were at the extreme end. Even though
My T levels were not the lowest he has seen.
My last 2 total T labs were 290 & 301
Last 2 free T's were 7.1 & 7.4 (10-30)

He said taking both will increase and balance my T levels
ASAP.  And that he will take me off the Gel after my 6 week follow-up
And start me on another medication (injection I believe)
To keep my testicals functioning??

I have to admit I was so relieved that a Dr. Was finally
Listening to me, and seemed to have all the "right" answers that I nearly
Broke down in tears in the office. (I actually did in the parking lot.)

I have taken a lot of notes of my symptoms
And to this point none of them have ever gone away
And I've had to live with them longer than the 3 years
I've been logging them.  I will start another post if/when
I see any symptom relief and the time frame involved as it seems to
Be a common question when starting treatment.  My Dr. Expects my to see
Some symptom relief by 2 weeks, but I know it's an individual thing.

Thanks to everyone on this forum for all the excellent (correct)
Advice!  Don't know if I would have gotten this far without all your support!
Hopefully my expierences will help someone else reading this forum in the future..

[makingsteel]

You are on your way back. Keep it up(no pun intended).

[PeakT]

Wow - your doctor sounds great.  How about that, guys?  A doctor that takes into account the symptoms of the patient?  Hmmm....

So what did he tell for why some docs miss the diagnosis out of curiosity?

[Prsartist]

He Said the medical guidelines total testosterone ranges
Of 240-1050 were originated from testosterone studies of
"all men" and in no way should the low end of
That scale be considered "normal"

He said my "optimal" range should fall in the 6-800 range.

[PeakT]

He would have had to treat me for a concussion after I passed out and hit the floor. 

[Prsartist]

Everytime I think about this it makes me angry.
This shouldn't be a big mystery to the majority of the medical community!

[PeakT]

Not any more - I agree.  There are tons of studies out there.  There's been a real time lag in catching up to the research for some reason...

All I can say is:  spread the word!