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  • #31
    call them asking up front how many male hormone patients the doctor saw

    Great idea - so simple that I probably never would've thought of that. Now that I think about it, it does seem rather stupid that I spent more time shopping for a new coffee maker than I did looking for a new doctor.

    My original thinking when choosing my internist (after my endo retired) was that he also specializes in HIV medicine. Since many HIV patients also take TRT, I thought he would be well versed in it. After a couple of years, I have realized his approach is way too "passive" so I'm shopping for a new endo as well.

    Another idea came from a friend in CT who is a transgendered guy. He's been on TRT for over 5 years and really likes his endo up there. His suggestion was to find an endo in my area who deals with trans patients and would most likely be well versed in TRT protocols.

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    • #32
      One thing to be prepared to do for an initial consult is to travel far. Unfortunately, while there are plenty of endos around who see lots of patients with diabetes and thyroid problems, just to name two of the more common causes bringing patients to endos' offices, male hormone concerns simply don't get as much coverage, especially outside of urban areas where at least there is a great concentration of endos.

      The endo I wound up seeing is easily an hour away from my house. However, this shouldn't be an issue long term once a patient is set up on an appropriate delivery system and dosage. New prescriptions can be handled by mail without the doctor necessarily having to see the patient. In my own case, I have my Rx handled by my oncologist's nurse practitioner (I see my oncologist regularly) and have essentially stopped seeing my endo now that I know I'm doing fine with my current dosage. Should I ever have a problem, I know he's only a phone call away.
      TC1: 1996, right orchiectomy, seminoma stage I 3.5 cm mass, radiation therapy (peri-aortic & pelvic 27.3 Gy)
      TC2: 2008, left orchiectomy, seminoma stage IA 5 cm mass, left & right prostheses, AndroGel TRT, surveillance at MSKCC

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      • #33
        Originally posted by 85Wahoo View Post
        (...)Another idea came from a friend in CT who is a transgendered guy. He's been on TRT for over 5 years and really likes his endo up there. His suggestion was to find an endo in my area who deals with trans patients and would most likely be well versed in TRT protocols.
        Very true. That certainly narrows the field to endos who at the very least are very much experienced in male hormones since female-to-male men have to be on them.
        TC1: 1996, right orchiectomy, seminoma stage I 3.5 cm mass, radiation therapy (peri-aortic & pelvic 27.3 Gy)
        TC2: 2008, left orchiectomy, seminoma stage IA 5 cm mass, left & right prostheses, AndroGel TRT, surveillance at MSKCC

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        • #34
          Originally posted by Aegletes View Post
          One thing to be prepared to do for an initial consult is to travel far.

          The endo I wound up seeing is easily an hour away from my house.
          Heh, the closest GP is 25 minutes from here, 45 minutes to most specialists & the hospital. Near as I can tell there are less than a half dozen endos about an hours drive. I bet none of them will have a clue...

          Dave
          Jan, 1975: Right I/O, followed by RPLND
          Dec, 2009: Left I/O, followed by 3xBEP

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          • #35
            This is an interesting article: http://www.usdoctor.com/NewPage/test.html.

            Some snippets that caught my attention, which are known to many frequenting this board:

            In Europe, a more sensitive test of Free Testosterone function is measured. It is called the F.A.I.; free androgen index. This is my definitive test. The value is determined by dividing the level of total testosterone by the sex hormone binding globulin.

            Lastly, measurements of FSH (follicle stimulating hormone) and LH (luteining hormone) are elevated in more men than ever considered: I find them elevated in 50% of the men with complaints of "andropause." Normal values are less than 5; often much less.

            Men on testosterone replacement should take 160 mg of Saw Palmetto with Pygeum twice daily. This herb will block the conversion of testosterone to dihydrotestosterone (DHT) which affects prostate hypertrophy and possibly cancer development. There were no significant side-effects to this herb. In higher dosages, it is registered as Proscar®.

            High levels of estrogen and sex hormone binding globulin reduce bio-available testosterone. Medical publications show that gels and patches raise sex hormone binding globulin. High levels of testosterone from an intramuscular injection raises the estradiol level. That is why low-level, even release pellets are the best modality available today for the man who needs testosterone replacement.
            7/2010: stage 1B mixed NSGCT. Left I/O + 1X BEP. TRT (pellets). All clear as of 8/2012

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