I'm a little worried about my doc

[Emjay]

Hi all,

I had my 6 month checkup for HRT last week and I'm a bit concerned and wondering what everyone else's take on this is.

I've been on HRT for about 2 1/2 years now, with the same doctor.  He's an amazing man and always good with me when I go to see him but I've always kind of wondered about the care I'm getting.  I've always wondered if my dosages were correct, they just seem a little low to me and I ask at every appointment but he says they're keeping my levels right where they should be so I've believed him.  I've been *ok* with my results, I know we don't all hit the genetic lottery and I am in my early 40's but had thought I'd have better results than I have. 

But......

What really has me worried is that he only checks my levels once a year, which happened during my spring appointment.....  in April.....  When I went in last week he said that my T had jumped back up to something like 568 and he thought that was weird and that he wanted me to get them checked again.

SIX MONTHS AGO?  He waited six months to let me know?! 

Does this seem a little weird to you all?  I'm pretty concerned and wondering if I should start looking for another doctor. 

Thanks!

[Dena]

Been there sort of and done that. Hormone levels weren't tested on me but I was to call about a week after my exam for test results. I would call multiple times and not get my results until the next visit. Sometimes I think he was a consultant for a drug  company  and didn't have the time for me and when I got a copy of my medical records, I discovered part of the last set of lab records were missing. Have a talk with your doctor and if you can't get the service you deserve, time to look for another doctor.

[becky.rw]

Most (or at least most should) these days provide online access to lab results almost as soon as the office gets them.  I think mine likes to look them over real quick before releasing them to the online system, but its just a "did this test blow up or something" kind of check.

oh, and just a funny observation, my baseline T is in the 400's and thats more than enough to make me bat**** nuts.  lol.   something's definitely odd.

[Emjay]

Thanks for the replies.

I have the same kind of thing going on Dena.  I tried calling for results when I first started seeing him and could never get a return phone call, which was annoying.  As time went on and things became routine I guess I just came to expect that everything was ok as long as I didn't hear anything.  It just seems like his office should have let me know that something had gone this much awry before my next checkup.

He does not offer online test results as far as I know.  His practice is unaffiliated with any hospital and very small so that's probably why he doesn't offer it. 

I'm not sure what my baseline was, I never got that info either.....  Maybe I'm just way too trusting lol.

[jentay1367]

Get another Dr...., this is your health and he seems to only have a passing interest. There are no do-overs. You deserve better. Remind him thay you pay him...not the other way around. He, works for you. Let him know what your expectations are.  Then ask him if he can meet them. Squeaky wheel gets the grease, hon. Always has.

[Rachel]

Get another doctor. Your T is too high (in my opinion, I am not a doctor) and your doctor seams ambivalent. Where I  go I get my labs on-line through a patient portal. My labs are run every quarter and are rock solid. If I had an issue I would e-mail my doctor and get a response within 2 work days. Where I go there are 9 practitioners and they treat almost exclusively trans and are very experienced.

If I try to stretch out my labs I get a phone call to make an appointment just for labs. The last time I went something went wrong with the labs and one element could not be read and they called and I had to repeat the blood draw. If there is an issue I get a call and get a doctor to explain what is going on and get instructions. This happened when my iron was low (I was eating no meat, now eat fish). They kept hounding me and taking blood until the issue was corrected.

[Maybebaby56]

Hi Emjay,

I will join the chorus.  Get another endocrinologist. Your testosterone is way out of the female range, which varies, but should definitely be < 100 ng/dL.

The worst sin is your doctor is not listening to you.  I had a similar problem.  My endocrinologist seemed indifferent to the fact my estradiol levels were barely above the male range after ten months of HRT.  I was having menopausal symptoms like night sweats and heart palpitations, since my T and E were both very low.  He begrudgingly started me on oral estradiol, but by that time I had arranged to see another endocrinologist.  He is now my former endocrinologist. I have a new endo, a new drug regimen, and no longer have menopausal symptoms because my serum E2 levels are four times higher.

Medical care is a two-way street, and communication is important. It's your body and your life.  You have a say in all this!  As others have said, lab results are usually available online within days.  Don't feel guilty about wanting adequate medical care.

With kindness,

Terri

[Deborah]

I'm not an Dr either but I did go to see my endo on Friday.  I expressed concern that my T had gotten too low, <3, and she assured me that it was fine.

Your T level is right at average for a male.  So something is definitely wrong with your doctor's regimen.

Hormone levels alone though are not the full story.  All the other blood markers need to stay in balance at the same time.  If you had access to your tests you could see if there was something going on there to cause your Dr concern or if he is just not prescribing the right meds and dosages.

I'll also join the chorus in saying you should be able to access all those tests online as soon as they are done.  Both my civilian endo and my primary care in the military provides this.  They also have online services where I can communicate with them if I have a concern.

If you can find one, a new Dr that provides these sorts of things would help you a lot.

[Emjay]

Thank you all for the replies, I really appreciate it.

I've always wondered about my regimen but this last appointment was a HUGE red flag since he let it go six months without saying a word.  And then it was just "oh by the way...."  I was freaking out when he said that.  He has said in the past that my T levels were around 40-ish so I can't imagine what went wrong as my dose hasn't changed at all but obviously something has.

There is a hospital here that has a new transgender care unit.  I'm going to give them a call Monday to see about going there instead of where I have been going.  I think it's definitely (past) time to start taking action.

[.Christy]

That's kinda irresponsible of him...

Whenever I go get my labs done my doc has her secretary call me to tell me the results as soon as possible even if they're normal. And during my trimester checkups we go over the labs again and if i tell her i want a printout of the them she'll give it to me no questions asked.

Yeah..look for another doc.

[Mikka55]

I have a question about switching doctors.   Do we need a new refferal from a gender therapist to get a new doctor?

[becky.rw]

At this point, we've all failed to mention, there is at least one T blocker that simply blocks receptors and doesn't prevent production.  The produced T simply has no where to go.    The poster didn't mention which approach their doctor was taking.    Both are valid enough...

Though I prefer...

NUKE IT FROM ORBIT, ITS THE ONLY WAY TO BE SURE!

[Emjay]

I have a question about switching doctors.   Do we need a new refferal from a gender therapist to get a new doctor?

Good question, I was wondering that myself actually.  I'm hoping they can just pull my records from my current doctor or that my original letter will suffice.  I guess I'm about to find out either way....  If I think about it I'll post here what happened.

At this point, we've all failed to mention, there is at least one T blocker that simply blocks receptors and doesn't prevent production.  The produced T simply has no where to go.    The poster didn't mention which approach their doctor was taking.    Both are valid enough...

Though I prefer...

NUKE IT FROM ORBIT, ITS THE ONLY WAY TO BE SURE!

Excellent reference to Aliens!

I'm not sure which one you are talking about but I am taking Spiro and Finasteride as blockers fwiw.

[Deborah]

Spiro, progesterone, and estrogen lowered my blood levels of T to <3 from 826 ng/dl.  But it took awhile to get there, over a year, and also required increasing the spiro to what is generally considered the max dose.

[Iwantboobs68]

Ive only just started my journey around 3 months on hormones, althou my GP is fab she didn't know much about a T girl, she has been really good about this and finding the information she needed.
But i also found a great doctor here in the uk who offers a great service her name is Dr Webbley, although her service is online to me she is second to non with help and support, maybe if any girls are looking for a great doctor.

[Emjay]

So, to update my situation:   I had blood drawn as requested by my doctor a week ago Friday, the people at the lab told me my doc would have the results by Monday (last Monday).  One week later and nothing from my doctor's office as far as results......

Yeahhhhh........  I'm thinking definitely new doctor time.   My numbers were wonky over six months ago and no mention and now I can't get any info still?   Not cool........  plus I'm freaking out about the whole thing now.

I've got a call in to another doctor's office.   I'm hoping they can take me on as a patient.  I'm so over this..... 

[jentay1367]

When you find a new Doc, you ought to call your old one to let him know he's fired....and why. Most people never say anything negative to their Doctor so they'll never have a clue that you're dissatisfied.  They absolutely deserve to know what bozos they actually are. Get em' off their high horses and bring em' back to earth. Give them an opportunity to take cause for pause.


Good luck in your search!!!