maxmuscle1
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- Apr 4, 2015
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So I was looking at all the online & local mens health or Medical spa or Anti Aging HRT/TRT comments about pricing in 2021-2022. Just seeing all the different pricing structures & protocols (if they make you do all labs, buy Rx’s, accept insurance, etc) . The first thing I run across is a Endocrinologist, MD taking about how he makes guys go through a ton of money/testing and basically “100% trying to no prescribe testosterone for any man!”
Exact copy of his post on Reddit
(it may help you avoid thinking about going to a top endo or urology clinic and stick with the places that actually want to help men!
————————————————————————-
As an Endocrinologist, I see a lot of men inappropriately started on testosterone therapy based on 1 low afternoon total value, etc. this is typically what I do:
I tell them that the diagnosis of low testosterone has specific criteria, and that it has many different causes.
I explain secondary vs primary, and the inability to do a proper work up while on testosterone therapy. After I tell them they could have pituitary disease/adenoma or testicular damage and the only way to tell the difference is to allow for proper evaluation, most men are fine to pause therapy. I also let them know I won’t prescribe T without a proper work up to ensure proper diagnosis/treatment.
I advise them to hold testosterone for 6-8 weeks, then follow the Endocrine Society guidelines (they also have a great app that walks through the diagnosis I will sometimes share with my patients as well). At the end of 6-8 weeks, I get an 8-9 AM total and free testosterone (free testosterone needs to be by equilibrium dialysis to be accurate). If low, I will repeat again with FSH/LH to identify source, and hct/psa to identify barriers to therapy. If primary I look for primary sources, if secondary I’ll get iron studies (I’ve caught a few hemochromatosis patients this way), check other pituitary labs, and will consider MRI.
Please always get a prolactin before starting or continuing therapy on a patient that has never had 1 checked (and in my experience a lot of these “Men’s health clinics” don’t check). If their low T is from hyperprolactinemia they don’t need T, they need cabergoline.
If they don’t qualify for therapy, I let them know that their symptoms aren’t from T deficiency because they don’t have T deficiency, and I let them know about potential issues (erythrocytosis, infertility, testicular shrinkage, prostate issues, etc). Most guys are comfortable stopping if that is the case. If not, I let them know I won’t be writing T bc it is not indicated, so a lot choose to go elsewhere. This can be frustrating, but at least you did the right thing medically.
If they DO qualify for therapy, I also discuss side effects and screen for OSA/prostate issues. If possible OSA, I do a STOP-BANG and refer for a sleep study. If positive, I wait 3 months after CPAP to see if resolution of low T and to make sure OSA doesn’t get worse on T therapy. If LUTS, I do an international prostate severity score and refer to Urology or advise PCP to manage before T is started.
Stopping this is hard. I try to do my part with each individual patient I see to at least make sure they are diagnosed correctly. There likely could be some reporting to medical boards since T is a controlled substance, but I’m not aware of any action against providers for T therapy.
On mobile if issues with formatting.
————————————————————————
Obviously he has been brainwashed by the US “Endocrine Society Guidelines” and definitely is a total F*****! Can you imagine all the appointments, labs, procedures, sleep studies, more labs, his short treatment (if any), and how he greases the Palms of every other type of provider in his city! That is truly what he is doing, he is trying to make himself a ton of money(and the other specialists he refers you too) . This is all due to greed, poorly passed laws based on completely false information provided by FDA/GOV/IOC:WADA(Olympic committee) WHO/CDC & Professional Sports Organizations. These Physicians and theirMD/NURSING Associations plus the acronym centers should be sued for writing these massively fucked up Guidelines that almost 98% of all men couldn’t afford let alone make all these appointments.
**I was so irate reading his post, but did not comment. I would like to see equal (female and males hormones classifications as an Rx medication not a Schedule 3 drug which puts you in Legal Trouble, the same prescribing guidelines and accessibility for all practitioners and the male patients .
Depo-Provera, Depo-SubQ Provera 104, All Progestins/Progesterones/conjugated estrogen and all HRT are not even scheduled for females unless they have male hormone inside, they are just an Rx drug . In fact, an OTC hormone is available for females at most stores(Levonorgestrel) Plan B for emergency contraceptive purposes. Where is our oral or injectable male contraceptive (Rx or OTC) ? They have only had 45 yrs of clinical trials & 10’s of thousands of studies yet…NOT ONE MALE HORMONE HAS BEEN AVAILABLE FOR CONTRACEPTIVE PURPOSES! They have made at least 100 drug formulas using types of male hormones. MENT:Trestolone (7α-methyl-19-nortestosterone) and it’s cousin DMAU have been the closest to being approved but they don’t want ANY male androgens/anabolic hormones to be EVER available for men. Trest has been studied since the early 90’s as a male contraceptive. Mixes of esters and mg can be over 90% effective . Nestorone
(NES) and Testosterone (T) Combination Gel for Male Contraception is still in trials after 10yrs !
As of Apr 12 2022 , here is what they are making for us - Male Birth Control Pill Expected to Start Human Trials This Year
The new
non-hormonal pill 
was 99 percent effective at preventing pregnancy in mice ! They won’t give us hormones and it’s all due to money and lies . More than 12,000 presentations & formulas have been made on oral or injectable male contraceptive.
Currently, men have only two effective options for birth control: male condoms and vasectomy!
Max
Mice
drug
Exact copy of his post on Reddit
(it may help you avoid thinking about going to a top endo or urology clinic and stick with the places that actually want to help men! ————————————————————————-
As an Endocrinologist, I see a lot of men inappropriately started on testosterone therapy based on 1 low afternoon total value, etc. this is typically what I do:
I tell them that the diagnosis of low testosterone has specific criteria, and that it has many different causes.
I explain secondary vs primary, and the inability to do a proper work up while on testosterone therapy. After I tell them they could have pituitary disease/adenoma or testicular damage and the only way to tell the difference is to allow for proper evaluation, most men are fine to pause therapy. I also let them know I won’t prescribe T without a proper work up to ensure proper diagnosis/treatment.
I advise them to hold testosterone for 6-8 weeks, then follow the Endocrine Society guidelines (they also have a great app that walks through the diagnosis I will sometimes share with my patients as well). At the end of 6-8 weeks, I get an 8-9 AM total and free testosterone (free testosterone needs to be by equilibrium dialysis to be accurate). If low, I will repeat again with FSH/LH to identify source, and hct/psa to identify barriers to therapy. If primary I look for primary sources, if secondary I’ll get iron studies (I’ve caught a few hemochromatosis patients this way), check other pituitary labs, and will consider MRI.
Please always get a prolactin before starting or continuing therapy on a patient that has never had 1 checked (and in my experience a lot of these “Men’s health clinics” don’t check). If their low T is from hyperprolactinemia they don’t need T, they need cabergoline.
If they don’t qualify for therapy, I let them know that their symptoms aren’t from T deficiency because they don’t have T deficiency, and I let them know about potential issues (erythrocytosis, infertility, testicular shrinkage, prostate issues, etc). Most guys are comfortable stopping if that is the case. If not, I let them know I won’t be writing T bc it is not indicated, so a lot choose to go elsewhere. This can be frustrating, but at least you did the right thing medically.
If they DO qualify for therapy, I also discuss side effects and screen for OSA/prostate issues. If possible OSA, I do a STOP-BANG and refer for a sleep study. If positive, I wait 3 months after CPAP to see if resolution of low T and to make sure OSA doesn’t get worse on T therapy. If LUTS, I do an international prostate severity score and refer to Urology or advise PCP to manage before T is started.
Stopping this is hard. I try to do my part with each individual patient I see to at least make sure they are diagnosed correctly. There likely could be some reporting to medical boards since T is a controlled substance, but I’m not aware of any action against providers for T therapy.
On mobile if issues with formatting.
————————————————————————
Obviously he has been brainwashed by the US “Endocrine Society Guidelines” and definitely is a total F*****! Can you imagine all the appointments, labs, procedures, sleep studies, more labs, his short treatment (if any), and how he greases the Palms of every other type of provider in his city! That is truly what he is doing, he is trying to make himself a ton of money(and the other specialists he refers you too) . This is all due to greed, poorly passed laws based on completely false information provided by FDA/GOV/IOC:WADA(Olympic committee) WHO/CDC & Professional Sports Organizations. These Physicians and theirMD/NURSING Associations plus the acronym centers should be sued for writing these massively fucked up Guidelines that almost 98% of all men couldn’t afford let alone make all these appointments.
**I was so irate reading his post, but did not comment. I would like to see equal (female and males hormones classifications as an Rx medication not a Schedule 3 drug which puts you in Legal Trouble, the same prescribing guidelines and accessibility for all practitioners and the male patients .
Depo-Provera, Depo-SubQ Provera 104, All Progestins/Progesterones/conjugated estrogen and all HRT are not even scheduled for females unless they have male hormone inside, they are just an Rx drug . In fact, an OTC hormone is available for females at most stores(Levonorgestrel) Plan B for emergency contraceptive purposes. Where is our oral or injectable male contraceptive (Rx or OTC) ? They have only had 45 yrs of clinical trials & 10’s of thousands of studies yet…NOT ONE MALE HORMONE HAS BEEN AVAILABLE FOR CONTRACEPTIVE PURPOSES! They have made at least 100 drug formulas using types of male hormones. MENT:Trestolone (7α-methyl-19-nortestosterone) and it’s cousin DMAU have been the closest to being approved but they don’t want ANY male androgens/anabolic hormones to be EVER available for men. Trest has been studied since the early 90’s as a male contraceptive. Mixes of esters and mg can be over 90% effective . Nestorone
(NES) and Testosterone (T) Combination Gel for Male Contraception is still in trials after 10yrs !As of Apr 12 2022 , here is what they are making for us - Male Birth Control Pill Expected to Start Human Trials This Year
The new
non-hormonal pill 
was 99 percent effective at preventing pregnancy in mice ! They won’t give us hormones and it’s all due to money and lies . More than 12,000 presentations & formulas have been made on oral or injectable male contraceptive. 
Currently, men have only two effective options for birth control: male condoms and vasectomy!Max
Mice
drug
