You want a doc who treats male hormone issues as a regular part of his/her practice. Your doc will probably suggest an endocrinologist or urologist, but many don’t know male hormone therapy, or are even philosophically opposed to it. I suggest you research & find a specialist yourself. Here are some tips:
For compiling a list of "SUSPECTS" near you, try:
Back trace docs from pharmacies that sell them male hormone products:
College Pharmacy (Colorado Springs, CO)
click "Find a Health Care Provider". There's a form to fill out. Submit the form & they'll e-mail a list of docs nearest you. In the “I would like to find a provider who specializes in:” I suggest choosing “Pellet Implants”; you might not want them but those docs know most other therapies too.
Bartor Pharmical (Rye NY) They manufacture testosterone pellets (docs who do pellets also know most other therapies). Call 914-967-4219 and ask if they can recommend three docs near you.
Women’s International Pharmacy (Madison, Wisconsin
Kronos Compounding Pharmacy (Las Vegas, NV) has a list of docs:
ApothéCure (Dallas, TX)
DOCTOR SEARCH. NOTE: THERE MAY BE PLENTY OF “OLD SCHOOL” OR OTHERWISE INCOMPETENT DOCS ON THESE LISTS. SCREENING PRIOR TO THE FIRST APPOINTMENT IS STILL ESSENTIAL.
Docs who have shown an interest in treating male hypogonadism can be found at:
Life Extension Foundation, List of Innovative Doctors:
American College for Advancement in Medicine (ACAM). Look for docs with “HRT” listed in their practice codes.
There’s an AACE docs search page at:
In theory they would use the AACE Hypogonadisn Guidelines,
but are still too “old school”.Confirm they treat hypogonadism prior to a visit.
To pre-qualify and select the right doc, call him or his staff and ask: how many men he/she treats for hypogonadism, if he/she offers hCG therapy in addition to TRT, if he/she uses Arimidex to keep E2 down, and checks for Primary or Secondary Hypogonadism.
You have time to ask the doc some pre-screening questions (probably through his/her staff). Like: What does he think about the AACE hypogonadism guidelines? (American Association Of Clinical Endocrinologists Medical Guidelines For Clinical Practice For The Evaluation And Treatment Of Hypogonadism
In Adult Male Patients—2002 Update, available in the Files section here. How many hypogonadism patients does he treat? Does he ever use hCG treatment? Does he regularly test for estrogens, specifically estradiol? Does he ever prescribed anything to keep estradiol down? Does he use a stimulation test to determine hypogonandism is primary or secondary? Does he ever use hormone pellet implants?
Did your doc mention that TRT like Androgel can make you sterile? If your marriage plans might include having children. A different treatment than testosterone supplementation would be needed. It would involve taking a hormone that stimulates the body's ability to make testosterone.
IMO, a complete range of initial tests should be done, way above and beyond the total testosterone levels you had tested. An hCG stimulation test (or similar) should be done to see if your body can respond to stimulation.
Also, here are the list of tests you'll want done. This can be very expensive depending on insurance.
Total Testosterone
Bioavailable Testosterone (sometimes called “Free and Loosely Bound”)
Free Testosterone (if Bio T is not available)
SHBG
DHT
Estradiol (specify by the “Extraction Method” or “Ultra-Sensitive”)
Total Estrogens
LH
FSH
Prolactin
Cortisol
Thyroid Panel (TSH, FT3, FT4)
CBC
Comprehensive Metabolic Panel
Lipid Panel
Homocysteine
PSA (if over 40)
IGF-1 (if HGH therapy is desired)
Fasting Insulin
