Someone like Cha's doc who keeps a close eye on everything while prescribing a low dose of T seems like she's following a pretty good strategy.

If you extapolate something like that further and challenege a doctor to ride the edge of what could be considered safe and healthy and thus increasing your T to the higher end of optimal, I think it would be an indicator of the doctor's ability, care and duty towards the patient and grasp on the subject and not just monetary factors like QB mentioned.

That is where I disagree with QB. Sure there are many C-grade practitioners who do exactly that and although I have never taken a medical ethics class, I know that is wrong but you should not discount the other spectrum of these ethics which have to deal with doing your utmost best with your patient and also being on top of your game.

My endo works in the OPD of a hospital and sees not a dime more no matter how intensive his work with me is.

I will also add that with something like Orthopedics for example - there seems to be the top 2% doctors who are really good and then there is a huge fall from the cliff and the rest are medoicre practitioners with dated clinical wisdom that is actually hurting their patients rather than helping

Is this the same with your standard Endocrinologists? I wouldn't be surprised.

What are some of the (dis)advantages of having low(ish) natural E2? I'm in the same boat there with 17 on my last test combined with 310ng/dl total T.

I regret not ever having my free test tested, because the more blood results I see, the more it seems like there is in fact quite some discrepancy between total/free T level correlations.

The internet statement "it's uncommon for someone with high T to have low free T and vice versa" doesn't really seem to hold much value. Specifically looking at SS's initial 358T+13.7FT vs Pummi's 635T+9.8FT. Sample size though.

EDIT: I guess it's pretty impossible to tell how much actual "difference" there is between someone with either 10 or 15pg/mL free test, since there's so many other things to consider. Like, I wonder from which point positive effects start getting noticeable. Or at which point someone has an actual hormonal advantage over someone else. In which way is having high (800) natural total test more beneficial compared to someone with only 400, if both of them have the same amount of free test and E2? So many questions.

Lower E2 should equal higher Free T, AFAIK. My very high SHBG is what's dragging my FT (and BAT) down.

Too low E2 is no good though, not sure what's considered too low.

I typo'd/misconverted the E2 and its unit, in my lab it's...

Normal/reference range that is commonly used seems to be:
10 to 50 picograms per milliliter (pg/mL).

Surely the E2 hormone does more than just regulate your free test levels, but a quick Google search reminds me of how much bigger this whole puzzle is, lol.

I have one old indian recipe for increasing your T and general hormones. I don't believe in it myself but my granddad (kabbadi master), his brothers and their father were all farmers and semi-pro wrestlers. My grandad's brothers were quite built too.

They never ate meat but probably had somewhere between 70-80g protein in their diet. However, what their diet used to be full of was Ghee. They swore by it.

Maybe their T and general hormones were superior because they spent their lives doing everyday heavy physical real man labor and wrestling other bearded Goliaths, whereas we are in a generation of masturbating in front of our computers/phones browsing pictures of cats and food 8 hours a day, talking about hormones on a card game forum.

YES.

- Be relatively lean and lift heavy things.
- Make sure your diet isn't deficient in important minerals like magnesium and zinc or essential fatty acids. Or D3.
- Don't overdo rec. drugs (incl. alcohol).
- Something something important I'm missing.

Everyone can do those things.
And if after all that the vitamin T is still low to the point it takes away from the quality of your life, time to explore TRT/drug options.

/My 2c.

ETA:
What sort of pisses me off is obese inactive peeps being prescribed exogenous T when they could most likely double their T values and more simply by fixing their diets, being more active and losing the flab.

Syn, you are right about the sitting in front of the computer part. Maybe my test is higher because I stopped doing that about 4 months ago. Drastic reduction in amount of sitting which lead my legs to be fatigued multiple days in a week before I adapted. Earlier I would watch porn for a couple hourd before jacking off but now since I am standing and it feels like a chore, 15 mins tops.

Yesterday I was playing poker for 8+ hours and maybe sat 3 hrs total during that period.

I went and double-checked my past tests and found some differences. Here are my numbers:

at the 12/1/11 test they also tested T4 which came in at 5.8ug/dl and the range is 4.5-12. nfi what that is.

I don't take any vitamins or medications or anything. In the past I have considered starting to supplement my diet w/ zinc and maybe other stuff. I don't really know enough about it so I never did it but it probably couldn't hurt, huh?

Your ETA: I def agree. Even look at my #s. I was fit at 28 when I got my first test taken and my numbers steadily went up from continuing to lift and eat better. **** works.

According to this book I'm reading on test/HRT, these are the basic hormones you should keep track of and make sure they're in harmony:

free T
bioavailable T
DHEA
pregnenolone
melatonin
androstenedione
progesterone
estriol
estrone
cortisol
estradiol
T3
T4
insulin
growth hormone

Interestingly enough it says that total T is utterly useless to monitor.

The only reason that I say those things is not because they are unknowable, it's just because I don't know what cha, for example, has posted about his doc.

As far as adding value to the thread, who knows. My main point is that if you want the highest level expert opinion on the subject you see an endocrinologist. A couple people in this thread have and they got the same response. That should give anyone who goes to these alternative practitioners some pause. As should the obvious financial incentives that these alternative practitioners have. It's clear that some in this thread get that, but I fear some may not.

As Pummi says, the truth probably lies in the middle. I think it's very likely that the mainstream endocrinologist realizes there is a lot we don't know about this stuff and realizes that prescribing these things to healthy guys is really just experimenting in a way. Mainstream docs hate doing this. However, it's clear that many people place such a high value on body composition that they're willing to experiment with unknown risks to get stronger and look better. However, the endocrinologist doesn't really pick up on this or agree w/ this value judgement so he and the patient reach an impasse.

The patient then seeks out one of these alternative docs. They don't really know any more, but they are more willing to experiment and they have a financial incentive to do so. They are also more understanding of the fact that being stronger is really important to some people. But since these guys tell the patient what they want to hear and do what the patient wants, people confuse their willingness to experiment for more knowledge. That's kind of a problem.

So I guess the real question is "If you really want to experiment with this stuff, what should you do?". The problem is that the people with the most knowledge generally don't want to use it in the way you would like, and the people who are willing to take a little more risk with the unknown and prescribe the stuff are generally not the most competent, qualified, and impartial people. If one is really determined, then here is probably what I'd do:

1. Go to one or more of the anti-aging clinics that QB suggests, find the one you're most comfortable with, and get on the drugs

2. After you're on the drugs, then see a good endocrinologist, and tell him "Here's the drugs I'm on. What are the risks? What do I need tested/monitored?" If you're already on the meds, the endocrinologist can't really give you the Monte treatment and will actually have to face your concern. Depending on the advice you get, you can continue with the anti-aging clinic alone, continue seeing both, or discontinue the drugs.

And, you're right, I'm guessing that no one has actually done this.

Good post

Plan C,

Find a bodybuilder you trust and have him help you out. Within their narrow scope of interest (getting normal males to build muscle and lose fat and look better naked) bodybuilders on average are undoubtedly much more knowledgeable than any GP or endocrinologist. Don't underestimate the power of empirical experience.

Of course, a major downside is you will probably have to be getting your supplements outside the law, so you have to worry about the quality of what you are getting.

Also, if you are getting drugs from an outside medical clinic I doubt your HMO endocrinologist is going to want anything to do with you. If he starts counseling you then he becomes liable, and no doctor wants to be liable for something a patient is doing with another doctor against their advice.

Also, I would guess a doctor at a boutique clinic that specializes in male hormone therapy is going to know much more than a general endocrinologist on this particular topic, for obvious reasons. And saying they are just guessing and experimenting is probably not fair.

There is always going to be some uncertainty because what works for one person may not work for another, but that being said for someone that really knows what they are doing and is diligent you are probably going to get good results with minimal side effects.

I can see why someone with very minimal info about the big picture could think some of this stuff, but you're really jumping to conclusions about things that you have absolutely no idea what you're talking about.

I found this doc because I read a book about natural hormones improving prostate health. I found her after doing lots of research. Everything she has said to me has been consistent with what I read in that book. She has no connections to the author or the book.

This doc treats men and women to make them feel and function better. She tries to get all your blood markers near the best level for you to function at and one of the goals is to make you live longer. She talks a lot about diet and exercise as being important and that stuff is as important as what she prescribes. My ex sees her as well and this doc has greatly improved her physical well being through diet, drugs, supplements, and sleep recommendations.

I've talked about my results from this doc in this thread, Syndr0m's and my log. Cliffs: I feel better and healthier now than at any point in the past 20+ years. Some of that is due to this doc, and some of it is related to food, sleep and exercise.


Most of those look familiar to me, but my doc monitors about 20 other things that are important in addition to that stuff.


I've been too busy to keep up more with this thread the past few days, and there is too much stuff in here for me to spend time addressing all of it. It looks like there's a lot of good stuff going on in here though.

The body builder may be better at optimizing your regimen for gains, but what he will definitely not be better at is counseling you about and assessing your risk for long-term side effects as well as appropriately screening. The studies on these risks are inconclusive, but it's not necessarily because the risks don't exist. It's because high quality studies with large numbers haven't been done. So it's very easy for your bodybuilder buddy or some anti-aging specialist there is no study that proves there is an increased risk of X if you take Y. Just because the study doesn't exist, doesn't mean that the risk doesn't.

This is not an invalid concern, but it's all about how you present your inquiry to the physician. If you say the right things, you'll create just as much liability for him turning you away.

I'd agree that like the body builder they're probably better at optimizing your regimen for peak performance. I doubt they're better at dealing with or care as much about long term consequences. And in that sense they absolutely are experimenting. No one really knows what this sort of stuff will do to your prostate cancer risk, for example, 30 years down the road. Obviously, one could make this claim about any drug, but in the case of hormones like T there is at least a plausible biological explanation why it could increase lifetime cancer risk.

I don't disagree that a guy that prescribes this stuff routinely has some advantages. That why I didn't suggest cutting the anti-aging specialist out of the plan. I just think that the endocrinologist is a good check on the system to help mitigate or at least make you more aware of the types of risks you're dealing with. The anti-aging specialist will give you the rosy picture, the endocrinologist will likely give you the bleak one, and you can use both to figure out what's best for you.

cha,

Would you be willing to post a link to your doc's website or give us a quick rundown of her credentials.

You called?

I read all of the thread up to this point and cross referenced with several logs. Without having seen any bloodwork, I would guess most of you don't have enough testosterone, but not for the reason you think.

Intense exercise is fueled by testosterone, but it is used and replenished on a reverse curve. Therefore, the more you work out, the less testosterone you will have. The most effective routines--assuming proper programming--respect the nonlinear relationship of testosterone to exercise.

Most of you fortunately don't work out often enough or hard enough to be beyond saving. Your body literally lets you know every time you go to the gym that more volume and/or high intensity is often not the right answer. Listen to your body. It wants to conserve your testosterone and use it for the proper purpose.

This is confirmed by reviewing the most successful lifters throughout history. You'll notice that most of them went on some form of TRT and/or other performance enhancement drugs. This was not to supplement their normal testosterone production--perhaps the greatest lie they ever convinced the public to believe--but to replace their natural production after too intense exercise programming destroyed their testosterone levels.

My motto for anyone serious about testosterone: Lift less. Live more.

I am working close to 18 hours shifts these days, but I'll check in from time to time to answer questions and perhaps write prescriptions for those in need.

Good luck to everyone.

Doctor BroScience

I think I posted most of this stuff in other threads, but its probably hard to find.

https://www.bodylogicmd.com/

https://www.bodylogicmd.com/physicia...arbara-schibly

cha,

Well she seems more qualified than a lot of the people out there who are prescribing this stuff. If she's got you on hormones, I still think it would be prudent at some point to see an endocrinologist and hear what they have to say about the whole thing.

I don't doubt that that you're feeling better after seeing this person, but I'm certain that a large part of it is sleep, nutrition, exercise and good old placebo effect. I'm not saying that adding drugs to that wouldn't provide additional benefit. It's just difficult for anyone, including you, to say for sure how much.

I also am quite skeptical that the whole practice of monitoring 20+ lab values and optimizing them for peak human performance has any high quality evidenced-based studies to support it. I think it would be interesting to get the endocrinologist to weigh in on this topic as well.

On the other hand, I doubt that much harm is going to come to you from all of this (at least not enough to outweigh the benefit you perceive) . Only downside is really the cost.

I agree that she's more qualified. That's one of the reasons why I go to her. I know there are a lot of quacks prescribing this stuff, and she is not one.

I know its not an endocrinologist, but I have a urologist who is treating me for a chronic prostate/bladder issue that is supportive of me doing this HRT.

The biggest things I notice are way fewer muscle adhesions to deal with and less soreness/easier recovery after lifting than before. There's zero chance this is placebo effect or nutrition or sleep related. It was a gradual effect that happened during the first several weeks I was on T. Sex drive is slightly improved, and everything seems to function a bit better. I feel a bit more energetic and generally sleep better. There's some chance some of that could be placebo, but I doubt it. I think the diet change, along with continuing to lift heavy weights, is what is recomping my body the most.

Wut? Not even fishoil? Or D3 through the winter months?
Those are pretty much a must in any diet that isn't called Inuit diet.

Zinc and magnesium optional but the cost is ~nothing so why not.
Some kind of multi-vitamin wouldn't hurt, either.

Ya, **** def works. I wish I had gotten T et al tested before touching a barbell for the very first time and starting to give a **** about diet.
Would be nice to have some historical data to compare to.