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Searching for Doctor is Yakima, WA

Discussion in 'Female Health & HRT' started by Kimmers85, Jul 10, 2013.

  1. Kimmers85

    Kimmers85 New Member

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    Hoping somebody can help my husband and I out in a search for a Dr in Yakima, WA area. My husband has been using testosterone therapy via IM injections for about 2 years. I am in perimenopause and in search of BHRT.

    I did purchase Suzanne's book and she only lists one Dr in the Seattle area.

    Your help is much appreciated!

    Thanks
    Kim
     
  2. JanSz

    JanSz Well-Known Member

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    Hi Kim

    Welcome

    Stick around. Learn with us. Bring your husband here.
    The more informed you are the better care you will be able to arrange for both of you.

    Describe your treatment so far.
    Your hubby could do it to, preferably all by himself.

    Hope you will like around here.



    --------------------------------------------------


    YAKIMA, WA Covers 7 ZIP Codes

    98901
    98902 largest population 46,322
    98903
    98904
    98907
    98908
    98909
    ---------------

    https://www.osteopathic.org/osteopathic-health/Pages/default.aspx

    Find a DO
    https://www.osteopathic.org/osteopathic-health/find-a-do/Pages/default.aspx

    Found 26 osteopaths within 25 miles radius.
    13 family medicine. 10 located within Yakima.

    Make calls to family medicine practice (all 10 of them), ask if they do what you need.



    ====================================================
     
  3. Kimmers85

    Kimmers85 New Member

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    Thanks for your quick response. I wish my husband would take more interest in his health but he wants me to do it for him and tell him what to do LOL. This is not a bad thing, it is my passion not his. I have been working for a MD for the past 5 years that dealt with mens/women's health using BHRT.

    Here is Brett's bio, 43, using 200 mgs cypionate IM weekly. He takes Erfa thyroid TID, cytomel 25 mcg BID. He is dealing with fatigue issues. Has suffered adrenal fatigue and has treated with Cortef the last 2 years. He is weaned off of it and uses 10 mgs PRN, which is seldom. View attachment IMG_0001.pdf View attachment IMG_0002.pdf View attachment IMG_0003.pdf View attachment IMG_0004.pdf View attachment IMG_0005.pdf View attachment IMG_0001.pdf View attachment IMG_0002.pdf View attachment IMG_0003.pdf View attachment IMG_0004.pdf View attachment IMG_0005.pdf

    Hopefully the attachments show up here. Cannot tell if they did. These labs were done in January, on this day he had taken DHEA 50mg, Erfa 60 mg TID, Cytomel 25 mcg 1D, and testosterone 200 mgs 2 days prior.

    Issues at hand, very low libido, afternoon fatigue, weight gain.


    Would love some imput,

    Thanks,
    Kim
     
  4. JanSz

    JanSz Well-Known Member

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    For easier review I have re-typed blood test results.
    Please review, add if I missed something.
    Clarify doctors notes on tests.

    Please post about Brett
    LH, FSH, prolactin, total testosterone, Hgb from before he went on testosterone injections.

    How long is he supplementing with testosterone.

    Brett's height, weight, body fat%, largest waist




    Brett should go ASAP and donate one pint of blood.
    Two weeks latter have him check Hgb, if too high, donate another pint of blood.
    Do not eat food rich in iron (liver, red meat, other)
    He should monitor his Hgb until stabilized, aim at Hgb=16,
    Do not show anxiety when discussing this with doctor, he may disallow testosterone use (that would be a setback).
    If Brett is not eligible for donating blood, ask for script for therapeutic phlebotomy.

    His SHBG and E2 are high.
    This really calls for increasing average weekly testosterone dose,
    but
    can't do that until his Hgb & E1 & E2 are at good levels and under positive control.

    Raising Total Testosterone should lower SHBG
    Raising Estradiol (and all other estrogens) should raise SHBG
    ideal SHBG=20
    acceptable 15<SHBG<25

    He needs to do
    Estradiol, sensitive test at LabCorp
    aim at
    E2(10-30)pg/mL
    Sweet spot for estradiol is highly correlated with good erections, specially nightly involuntary erections.

    Often man have a very hard time keeping estradiol under control, at one level and in one place.
    Often this is highly correlated with low in pregnenolone, progesterone, DHEAs and infrequent (weekly) testosterone injections,
    that is highly disruptive to achieving stable and good E2 & E1 levels.

    There is at least three problems with his current protocol.
    Infrequent testosterone injections
    Lack of HCG use
    Lack of Estradiol and other estrogens management
    Lack of pregnenolone & progesterone monitoring
    Low Cortisol

    All that have to be monitored and managed all at once.
    At this time I do not know what have strongest influence.

    Estradiol ---->Arimidex looks appealing and quick, hard to know if it is lasting problem
    Have him take one Arimidex/week (Total 2-3 pills, stop if he gets nightly erections)

    ------
    Cortisol, DHEAs, DHEA, melatonin have highest influence at energy levels.

    He must work on re-establishing his normal
    Circadian Rhythm.
    That is two prong program.
    1-Steroid Hormones Optimization Program
    2-Life style changes conducive to maintaining good Circadian Rhythm


    -----------
    Divide Weekly Testosterone dose into EOD Every other day injections.
    Add 250iu-HCG-injection EOD
    For each use only this syringes, inject everywhere where comfortable, use (90 degree but no less than 45% angle when injecting with one hand only, do not touch skin around injection area with the other hand)
    BD Ultra-Fine II U-100 Insulin Syringes Short Needle 31g 3/10cc 5/16in

    Recheck in one month after implementing.

    ============================================

    2/day-->Super Selenium Complex, 200 mcg 100 capsules (lef.org)

    1 dropperfull/day=48mg/day
    Lugol's Iodine Family Pack -- 6 (2 fl. oz.) bottles
    http://www.amazon.com/Lugols-Iodine-Family-Pack-bottles/dp/B001RRP3FW
    recalculate dose if using other iodine/iodide source.

    7/day Biotic Research Bio-D-Mulsion Forte, 1drop=2000iu Vit D ---(aim at 100, current 31 is defficient)
    5/day CarlsonVitamin K2 Menatetrenone 5 mg (check via osteocalcin)


    Post his lipid panel
    do not eat statins













    =========================================

    43yo male (Brett)
    200mg/week cypionate IM
    Erfa thyroid TID = Three times a day---------------------------- (I assume it is 60mg ERFA)
    cytomel 25 mcg BID = Twice a day
    Cortef 10 mg PRN, "as needed" which is seldom

    Blood test done in January 10/2013 9:52AM, fasting
    on this day he had taken:
    DHEA 50mg, Erfa 60 mg TID = Three times a day , Cytomel 25 mcg 1D, and testosterone 200 mgs 2 days prior.




    GLUCOSE -------------------- 101H ------ 70-99 mg/dl
    UREA NITROGEN SERUM -------------------- 14 ------ (6-24) mg/dl
    CREATINTNE SERUM -------------------- 0.92 ------ <1.50 mg/dl
    GFR NON.AFRICAN AMERICAN -------------------- >60 ------ >60 mllminl1.73m
    GFR AFRICAN AMERICAN -------------------- >60 ------ >60 mllminl1.73m
    BUN/CREAT -------------------- 15 ------ ratio
    BILIRUBIN TOTAL -------------------- 1 ------ (0.1-1.4) mg/dl
    AST (SGOT) -------------------- 22 ------ <45 tU/L
    ALT (SGPT) -------------------- 31 ------ <50 tU/L
    ALKALINE PHOSPHATASE -------------------- 58 ------ <170 tU/L
    CALCIUM -------------------- 9.4 ------ 8.5-10.5 mg/dl
    SODIUM -------------------- 142 ------ 135-146 mmol/L
    POTASIUM -------------------- 4.3 ------ 3.5-5.2 mmol/L
    CHLORIDE -------------------- 108 ------ 96-109 mmol/L
    c02 -------------------- 26 ------ 23-32 mmol/L
    PROTEIN SERUM -------------------- 7.4 ------ 6.4-8.2 g/dl
    ALBUMIN -------------------- 4.8 ------ 3.7-5.0 sldl
    GLOBULIN -------------------- 2.2 ------ 2.1-4.A g/dl
    ALBUMIN/GLOBULIN -------------------- 2.2 ------ Ratio

    Bilirubin direct=0.2(<0.4)mg/dL
    Magnesium, serum=2.1(1.7-2.4) mg/dL

    TSH=<0.10 L(0.5-1.6)
    FreeT4=0.8(0.8-1.6)ng/dL
    FreeT3=3.0(2.5-3.9)pg/mL--------------------------- (uneligible doctor's note please transcribe)
    Reverse T3=121 (90-350) pg/ml

    DHEAs=203(95-350)ug/dL
    Cortisol random=6.4
    ( 8 AM : 4.3-22.4 ug/dL, 4 PM : 3.1-16.1 ug/dL) (blood drawn9:52AM)

    CRP,highly sensitive=0.34(<3) mg/L

    Testosterone Total=1234(285-950)ng/dL
    Testosterone % Free=2.0(1.8-32) %
    SHBG=46 (10-74)
    Albumin=4.8(3.7-5.0) g/dL
    Estradiol=52 H (<41) pg/mL-------------------------- (uneligible doctor's note please transcribe)




    Iron=189(40-200) ug/dL
    TIBC=412H(200-375)ug/dL
    Unsaturated binding=223(155-355)ug/dL
    % iron saturation=46(20-55) %

    Ferritin=51(20-320)ng/mL

    WBC=6.02 H (4.0-11)
    RBC=6.02 H (4.5-6.0)
    HGB=19.0 H (41.0-51.0)

    MCV=93(80-95)
    MCH=31.5(26-34)
    RDW=13(12-15)
    Platelet Count=162(150-450)
    Neutrophils% =63.9(40-80)
    Neutrophils Abs =3.0(1.8-7.6)
    Lymphocytes %=29.0(15-40)
    Lymphocytes Abs =1.3(1-4.8)
    Monocytes %=5.1(0-12.5)
    Monocytes Abs =0.2(0-2)
    EOS %=1.5(0-7)
    EOS abs=0.1(0-0.5)
    Basophils %=0.6(0-3)
    Basophil Abs=0(0-0.2)

    VITAMIN D 25 OH=31(30-100)------------------------- (uneligible doctor's note please transcribe)
    PSA, total=0.7((<4.0)


    Vit B12=1092 (>209) pg/mL


    /////////////////////////////////
     
    Last edited: Jul 11, 2013
  5. whitegato777

    whitegato777 Member

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    I have doctor here in tucson az that will do everything over the phone. He's pretty open minded but I can't get him to put me on hydrocortisone. His initial consultation is $180 and follow ups are $80. I asked if you would take out of state patients over the phone for consultations because I have family members in Washington and he said yeah that's perfectly fine.
     

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