question from a user
Age 62, athletic, nutrition freak (usa). Started TRT 15 months ago when testosterone at 298. Six months later it was 498 and I was doing great. Level has now collapsed to 202 despite increasing dose. Urologist will only do hemoglobin, psa, and testosterone level blood tests and is reluctant to refer me to endocrinologist despite me having a prior thyroid issue. I have great insurance. Mainstream theory suggests that other hormones kicked in to suppress testosterone level. I need a referral from my urologist to see endocrinologist as I called several. Changing urologists makes me look like I’m shopping for an opinion or meds. How do I handle this?
AlphaMD's Answer
I'll share some conjecture here without knowing more.
Taking everything at face value, I would say whatever medication you're taking might not be Testosterone Cypionate. When you take any Testosterone or Testosterone like substance, your natural production is reduced, and for a 6months-1year without any PCT after. This really isn't a big deal in normal TRT because when dosing for a patient you account for this and provide a therapeutic dose which would raise their levels for their need & for the suppression.
Without knowing more, it sounds like you had a low level, took Testosterone & it went to where it should, then you stopped having T & are now dealing with having nothing and suppression.
If that's not the case, and you're getting medication from a legitimate source, your thoughts may well be right. You seem like you might need an Estradiol test, especially if you know your previous levels. Perhaps you've started to aromatase more of your Testosterone into Estrogen. Are you taking any AIs?
Bottom line - You need care. Your Urologist is refusing to refer you to someone for care. Get a new Urologist who can refer you to an Endocrinologist who knows Men's Health if that's how your insurance needs it to work. Providers are here to work for you, if they're not, they're not doing their job.
Not all Urologists or Endocrinologists are created equal, and some are very dismissive of Men's Health concerns, if you're dealing with that it's not your fault for having to shop around.
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