Author Topic: I saw Dr. Savage yesterday... undecided  (Read 217 times)

wallofglass

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I saw Dr. Savage yesterday... undecided
« on: January 11, 2018, 07:21:57 PM »
Hi all,

Sorry, not really sure where on the forum this sits.

I went to see Dr. Savage in Doncaster yesterday for an initial consultation and tbh I'm not sure of what to do now. I'm in my 30s and have had symptoms that look like low T - lack of libido, lack of energy, lack of hair growth, mental health issues etc. I had it tested by my GP in March last year and it was around 16, then she referred me to an endo over elevated prolactin (now fine) and in September it was measured at 13.5 and the endo basically said whatever issues I have aren't hormonal.

I wasn't convinced so I arranged to see Dr. Savage, seeing various glowing reviews. I was a little surprised. I feel like the appointment was 80% Dr. Savage and 20% me. He seemed almost evangelical about TRT and immediately prescribed me Tostran. I was really prepared to go in and try clomid. Shutting down my T production and replacing it with an artificial version feels like a massive step to take when my levels aren't actually that low.

I asked about negative effects and tbh didn't get much of an answer. I was given the impression that it's very unlikely anything can go wrong, which seems too good to be true.

Not sure what I'm actually asking for here... Just any opinions or experiences of having a trial, I suppose.

Olly13

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Re: I saw Dr. Savage yesterday... undecided
« Reply #1 on: January 11, 2018, 10:01:06 PM »
Hi all,

Sorry, not really sure where on the forum this sits.

I went to see Dr. Savage in Doncaster yesterday for an initial consultation and tbh I'm not sure of what to do now. I'm in my 30s and have had symptoms that look like low T - lack of libido, lack of energy, lack of hair growth, mental health issues etc. I had it tested by my GP in March last year and it was around 16, then she referred me to an endo over elevated prolactin (now fine) and in September it was measured at 13.5 and the endo basically said whatever issues I have aren't hormonal.

I wasn't convinced so I arranged to see Dr. Savage, seeing various glowing reviews. I was a little surprised. I feel like the appointment was 80% Dr. Savage and 20% me. He seemed almost evangelical about TRT and immediately prescribed me Tostran. I was really prepared to go in and try clomid. Shutting down my T production and replacing it with an artificial version feels like a massive step to take when my levels aren't actually that low.

I asked about negative effects and tbh didn't get much of an answer. I was given the impression that it's very unlikely anything can go wrong, which seems too good to be true.

Not sure what I'm actually asking for here... Just any opinions or experiences of having a trial, I suppose.

Hey there, and welcome to the forum!

Hmm, this is a though one to he completely honest.

Have you had your LH and FSH tested? If so are you primary or secondary? If you're the former that will be why Dr Savage insisted on TRT over clomid.

Try not to take Dr Savage's passion for Testosterone as "evangelicalism" its not, its just confidence in what he does, however I know exactly what you are referring to, as I am a patient of his myself, but I placed my trust in him and it hasn't been wrong so far, and believe me I second guess and question everything, Nick can personally vouch for this... It's because none of us are used to a straightforward Dr which wants to help, so when we finally get that after jumping many hoops, it's a shock!

What concerns about "potential" risks do you have? Throw me some questions and I'll do my very best to help put your mind at rest?

If you have prior blood work then please share as it'll give a clearer picture of what's going on.

:)

wallofglass

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Re: I saw Dr. Savage yesterday... undecided
« Reply #2 on: January 11, 2018, 10:09:28 PM »
I actually have a full panel of results but annoyingly managed to leave them in Dr. Savage's office. Everything was in range and my calculated free T was something like 0.28 on the measurement Dr. Savage uses. I presume that means secondary (if at all).

I guess what I'm concerned about is whether there are any side effects I'm not aware of. Pretty much all I know is the... er... shrinkage. How bad is that? Do they still hang down?

My other worry is what if replacement lowers my levels. If my natural level was lower then it wouldn't be an issue, but since I'm not that low to begin with, isn't it possible that this could actually make it worse?
« Last Edit: January 11, 2018, 10:12:22 PM by wallofglass »

Olly13

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Re: I saw Dr. Savage yesterday... undecided
« Reply #3 on: January 11, 2018, 11:44:50 PM »
I actually have a full panel of results but annoyingly managed to leave them in Dr. Savage's office. Everything was in range and my calculated free T was something like 0.28 on the measurement Dr. Savage uses. I presume that means secondary (if at all).

I guess what I'm concerned about is whether there are any side effects I'm not aware of. Pretty much all I know is the... er... shrinkage. How bad is that? Do they still hang down?

My other worry is what if replacement lowers my levels. If my natural level was lower then it wouldn't be an issue, but since I'm not that low to begin with, isn't it possible that this could actually make it worse?

That's annoying for you.

Free Testosterone is only a useful measurement of... Well...just that really.

The tests which determine if you are primary or secondary  is the LH and FSH tests, if it's high it's means the testicles have failed, if it's low then it means the pituitary glad isn't producing LH and the testicles never get the message.

I'd imagine you are primary if Dr Savage insisted on TRT, as I know he likes to use clomid wherever possible. Although you'd need to ask him that.

Regarding the "shrinkage" it's not that's bad in my experience, people assume they turn into tiny raisins or something, this isn't the case, they do however shrink enough to notice, they do hang, but you'll find they sit a little higher and tighter, not a big deal really, doesn't cause any problems during sex either that I've found.

Whenever someone starts TRT there natural levels of production do indeed "shut down", so really it doesn't matter one itoa what testosterone level you start with in my opinion, as you'll be left solely with the replacement dose. However obviously the idea is to increase the testosterone to a decent level above what was there originally, so you won't be left with less, or not for long anyway, if it turns out you need a higher dose then that's what will likely happen, until a suitable level is achieved.

Other than that there isn't any real biggies to worry about, there is the increase in red blood count that occurs, but usually small and not of real concern, but it'll be monitored anyway no doubt, one other is oestradiol elevation which occasionally happens when testosterone is increased, again normally monitored and is extremely easy to fix, usually with an Aromatase inhibitor or dose reduction, and obviously there is a temporary decrease in fertility for the duration that you take testosterone, which can be resolved in the future with either HCG or coming of and using clomid temporarily, just to get the "factory" working so to speak.

There is however tons of risks siting hypogonadal and not treating it, such as osteoporosis, cognitive decline (alzheimers), increased risk of diabetes/metabolic syndrome, depression (as you know), and a massive increase in heart issues... Need I go on?

Any more questions then fire away? :)

wallofglass

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Re: I saw Dr. Savage yesterday... undecided
« Reply #4 on: January 12, 2018, 12:08:55 AM »
Hmm. The reason he gave me for not going with clomid was that it has a track record in raising T but not actually making people feel better. Frustrating that I don't have the numbers, but I'm pretty sure they were at the lower end of the range.

I get that natural T levels are pretty irrelevant if you're really low, because the replacement can't really make things any worse, but I'm thinking that if a fair amount of the gel rubs off on my clothes I could easily end up lower than 13.5, no?
« Last Edit: January 12, 2018, 12:11:10 AM by wallofglass »

MG

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Re: I saw Dr. Savage yesterday... undecided
« Reply #5 on: January 12, 2018, 02:21:04 PM »
Yes that's me ha its raised it on paper at least

nick

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Re: I saw Dr. Savage yesterday... undecided
« Reply #6 on: January 12, 2018, 09:35:17 PM »
Hi Wall,

If you give Doc Savage's office a call, I'm sure they will give you the numbers.

They are fundamental to any advice we can give, so please get hold of them,

Cheers,

Nick

nick

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Re: I saw Dr. Savage yesterday... undecided
« Reply #7 on: January 12, 2018, 09:37:51 PM »
Yes that's me ha its raised it on paper at least

It's not a miracle drug that will fix everything in your life. However it will allow you to function better. The rest is up to the individual.

Cheers,

Nick

Olly13

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Re: I saw Dr. Savage yesterday... undecided
« Reply #8 on: January 12, 2018, 10:29:02 PM »
Hmm. The reason he gave me for not going with clomid was that it has a track record in raising T but not actually making people feel better. Frustrating that I don't have the numbers, but I'm pretty sure they were at the lower end of the range.

I get that natural T levels are pretty irrelevant if you're really low, because the replacement can't really make things any worse, but I'm thinking that if a fair amount of the gel rubs off on my clothes I could easily end up lower than 13.5, no?

He might be onto something regarding clomid... However it does genuinely work for some, but not all, the success rate of TRT is slightly higher from what I've seen, but still worth a go for a guy who's secondary imho. I'll continue to remain on the fence about clomid.

If you don't like the sound of gel and the impractical problems associated with it then ask for Sustanon, this will eliminate near enough every caveat you've mentioned so far. I'm on Sustanon and it's been successful for me so I'm biased. Gel is still good don't get me wrong, however I'd hate to he slapping it on every morning for life, a jab means switching of for a few days or weeks.

:)

wallofglass

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Re: I saw Dr. Savage yesterday... undecided
« Reply #9 on: January 12, 2018, 10:32:24 PM »
Hi Wall,

If you give Doc Savage's office a call, I'm sure they will give you the numbers.

They are fundamental to any advice we can give, so please get hold of them,

Cheers,

Nick

He's got them and is posting them back, so should hopefully have them next week.

I'm gonna go pick up the Tostran tomorrow, but I don't know if I'll use it yet.

I think Dr. Savage's reasoning for trying get rather than injections is that he's not sure if it's a testosterone problem or not, so it's really just a trial at this point. If TRT does fix things, there's no way in hell I'd want to use gels forever. So impractical.

Olly13

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Re: I saw Dr. Savage yesterday... undecided
« Reply #10 on: January 12, 2018, 10:36:32 PM »
Yes that's me ha its raised it on paper at least

You know my opinion, if you don't think it's for you then don't sit and complain, pick up the phone, ring Dr Savage and ask for TRT! cost isn't even a factor, private prescription for Sustanon is ridiculously cheap per ampoule.

If no difference then revert back to the original plan with the clomid + ai, going on a short trial of TRT won't break anything, you're secondary anyway.

However I agree with Nick that Testosterone won't solve issues. Trust me. All the things I've achieved over the last year regarding my mindset, wellbeing etc are not solely from just testosterone, a lot of personal work has gone into it, obviously I wouldn't have been able to achieve it if I was hypogonadal, but you get my drift. :)

Olly13

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Re: I saw Dr. Savage yesterday... undecided
« Reply #11 on: January 12, 2018, 10:40:08 PM »
He's got them and is posting them back, so should hopefully have them next week.

I'm gonna go pick up the Tostran tomorrow, but I don't know if I'll use it yet.

I think Dr. Savage's reasoning for trying get rather than injections is that he's not sure if it's a testosterone problem or not, so it's really just a trial at this point. If TRT does fix things, there's no way in hell I'd want to use gels forever. So impractical.

Well, let's be honest, can it get any worse hormonally by using gel? Probably not.

Good luck whichever way you decide to handle this, I understand how tough it is :)

wallofglass

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Re: I saw Dr. Savage yesterday... undecided
« Reply #12 on: January 13, 2018, 08:50:33 PM »
Dr. Savage sent my stuff back. Here's the main bits, but there's more if you need it:

LH - 3.2
FSH - 3.0
Prolactin - 133
Oestradiol - 91.8
Testosterone - 13.5
SHBG - 26

Basically the important stuff seems on the low side but not dramatically so?

And I'm worried that TRT, particularly by a potentially unreliable method, could make things worse. If my T was at 4 or something then it wouldn't be an issue.
« Last Edit: January 13, 2018, 08:56:07 PM by wallofglass »

CM

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Re: I saw Dr. Savage yesterday... undecided
« Reply #13 on: January 14, 2018, 06:50:28 AM »
Very similar to my levels pre TRT though my T was 9 nmol. Clomid took me to low 20 nmols but felt really bad on it, kept at it for months. Switched to Sustanon and within 4 days felt like the old me. One thing I would say you have to be pretty much intune with your body as with injections if you go that route will likely have estrogen spikes (unless you go for smaller frequent injections). Everybody is different so a cookie cutter approach doesn’t always work.

wallofglass

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Re: I saw Dr. Savage yesterday... undecided
« Reply #14 on: January 14, 2018, 10:42:27 AM »
I'm leaning towards giving it a try, I think. I guess my main symptom is total apathy towards pretty much anything at the moment. All I want to do is sit around. No interest in socialising, no interest in sex, can't get engaged with my work etc.
« Last Edit: January 14, 2018, 10:57:56 AM by wallofglass »