@crypto_condom I’ve worked in the emergency department for 11 years and have yet to see ONE SINGLE cardiovascular event associated with therapeutic testosterone replacement therapy
@CoffeeBlackMD I think if the patient legit needs 200 to feel symptomatic relief , then fine. Most don’t. And the problem is cookie cutter clinics starting dosing at 200 then adjusting. I like to start at 140mg and adjust accordingly
@drmarlonperalta Yea i have a patient whose total testosterone is 740 with a free test of 9. I basically approach this in multiple ways. The normal lifestyle modifications to hopefully free up more testosterone, or I offer if patient would like to try TRT for 3 months or so and see if feels bettr
@drmarlonperalta Marlon….. I think there should be a little more context using free testosterone. What if a male has 600 total testosterone with a free testosterone of 6-8ng/dl.
Question, do you think this male could benefit from TRT to bring available free testosterone up to say 20-25?
@Max_hubz@0xMJTV Couldn’t agree more. He should also be optimizing fat loss and healthy lifestyle. I would imagine dehydration and likely sleep apnea have a lot to do with that hematocrit being high.
@TheCryptoDaddi I tried subq once in the lower belly fat and had a palpable lump that was painful for about a week. I do daily injections so I can’t imagine having this every single day, therefore I haven’t tried again since.
@dusapilled @Max_hubz It’s not hard to manage once you understand it. I would have to believe these clinicians just aren’t putting in the time to learn to be making such misguided treatment plans and recommendations
@0xMJTV@Max_hubz That answer is actually quite obvious …. They lost a patient who was paying them for TRT, so they found another way to keep him on the books. Obviously no appropriate.
@Max_hubz @dusapilled I wouldn’t be so quick to put down mid level providers man…. The stigma that a doctor somehow is good at TRT management makes no sense. Testosterone replacement therapy management isn’t taught in medical school.