Why does institutional endocrinology insist on horribly outdated treatment protocols, when modern evidence says they're wrong? eg: I asked my nearly elderly endo attending after she refused to up my dose to a reasonable level due to high normal HCT, why do they adhere so strictly to these outdated lab number guidelines? If these were such critical patient safety issues, then WHY ARE THE GUYS GETTING CARE AT TEST CLINICS NOT DROPPING DEAD LEFT AND RIGHT?

If you don't mind, I will be a bit blunt here because this kind of thing is the reason we started our company, so I hope it doesn't come off as overly rude.

Providers, even specialists, are people. They forget things, especially things they don't use every single day in & out. In many cases when it comes to TRT, they were given a passing glance at it a very long time ago when they were in school. People don't always care to be lifelong learners and not to be sexist but a lot of female endocrinologists who hardly deal with TRT for men aren't going to be passionate enough about it to care or learn the new science like a younger man is going to be. This comes from a place of routinely hearing stories like that where these endocrinologist start with the weakest treatments, require long testing periods, and consider the bare minimum as an acceptable standard of care.

There are other providers like PCPs or well intentioned endocrinologists who do want to help, but are aware of the hoops that insurance are going to make them jump through to have TRT paid for. In some cases, they know poor treatments like Clomid may be more likely to be covered or they know that above an arbitrary insurance determined Testosterone value and age, insurance will tell them hell no and pay for nothing. They get tired of dealing with the tape and just go for what they think will work.It's garbage.

Find someone who cares. I'm not saying to work with us or doing self promoting, I'm saying you have control. Find a new PCP, a new endocrinologist, a new insurance, something. You pay these people, don't settle.