Need a good endocrinologist in Toronto or GTA or even Ontario in general.

[Testiclops]

Hello.

Does anyone know of a good endocrinologist in the Toronto or the Greater Toronto Area? I want one who understands male health issues and isn't a moron, one who won't ignorantly appeal to the acceptability of being literally on the floor of the dubious "normal" range. If you don't want to post this kind of info in the thread, I would really appreciate a PM on the matter.

Failing which, does anyone know of a reliable, cost-effective way of running my own labs? Who is the best provider for this?

Brief history:

23 year old male. Been on several psychotropic medications since 14.

ADs: Paxil, Wellbutrin, Effexor XR, Celexa
AAP: Zyprexa, Seroquel
Benzos: Ativan, Klonopin
ACs: Lamotrigine

As well as a 5 month course of Accutane at age 16.

I have persistent sexual dysfunction from both Paxil and Celexa (that is, sexual dysfunction that has not gone away after discontinuance of the psychotropic agent). This includes trouble with erections (morning wood is an extremely rare event), premature ejaculation and severely lowered libido. I am not currently taking any psychotropic medications (and haven't been for at least 6-8 months) and I'm doing OK, although not as well as I'd like.

I did a hormone test and it has revealed low T, low LH, low FSH and possibly high estradiol (not sure). I only saw the values on an unrelated walk-in and will be going back next month for a more comprehensive visit with my GP (maybe.. if not I will just obtain the results). I only saw a glimpse before he closed the window (on the computer) so I am not positive about the estradiol. The others I am sure of. He said something of the T like "well it's still in the normal range, so...." even though it's on the floor of what is considered normal. Having less testosterone than the average 80 year old man is not okay with me. Typical family doctor bullshit.

My diet is very clean. I don't drink alcohol or coffee, I don't consume high GI carbs (I suspect hypoglycemia as type II diabetes runs in the family). I'm lean at approximately 150 lbs and 5"9, although I do have somewhat of a pear shape (a tendency towards fat below the waist) and also a tendency towards abdominal fat (although not as much as it is for fat below the waist). I go to the gym but not as regularly as I would like. I have never taken AAS.

That's it for now. Thank you in advance.

[ubcpower]

i was on paxil and celexa for about 6 months in highschool... kinda ****ed up my sex drive and functioning also

[Testiclops]

Why all that psychtropic medication from such a young age?
At first it was for OCD and PTSD. Once you start on all of this shit it's hard to get off of it and usually the drugs just keep on piling on. I had an antidepressant-induced manic episode over a year ago. After two hospitalizations and all sorts of shit, I had enough and decided I want off. I'm actually doing okay now.. I just need to start feeling better about myself, and the testosterone deficiency is a good place to start.

[Testiclops]

i was on paxil and celexa for about 6 months in highschool... kinda ****ed up my sex drive and functioning also
Did your sex drive and functioning return after discontinuance (or did it at some other time later in the future)?

[Big D]

search some post on gsxr750 I think he visisted a few endos in GTA

[ubcpower]

Did your sex drive and functioning return after discontinuance (or did it at some other time later in the future)?

The problem was only when i was on it (particularly paxil) . It had kind of a numbing sensation. Couldnt get full erections and couldnt climax. SOon as i went off, within weeks i was back to normal

[Testiclops]

The problem was only when i was on it (particularly paxil) . It had kind of a numbing sensation. Couldnt get full erections and couldnt climax. SOon as i went off, within weeks i was back to normal
I'm glad to hear that. Although I'm not entirely convinced, it may be possible that the people who have persistent issues after taking these drugs are more likely to acquiring these issues in the first place (due to a predisposition), although even if this is true, there is no way of knowing if they ever would have such issues in the absence of taking the drugs in the first place.

[clemenst]

i'm 24 yrs old and i'm on TRT now and i know its from the accutane. felt total normal before accutane and within 3 months of taking it, never been the same. but my face looks f*****g great!!!!. Don't waste your time with endos, been there done that, there useless........pm for a good doc.

[nisser]

Not sure how endos work but most specialists require a referral from a family doctor. Many fam docs won't be happy about referring you to a specialist of your choosing, since they likely have specialist friends (from school, friends, conferences, etc) that they funnel their patients to.

Just ask your family doctor. Endos are specialists and all of them should be knowledgeable about hormones; that's their specialty.

[warlock]

If you have coverage I'd tell you to see a ND as well.

Call the reception of your MD and ask for a copy of your blood work and you can just go there to pick up.

You should just ask your doctor what should be done if his answer is something like : "Accept your faith!: them you should get another doctor.

[Testiclops]

i'm 24 yrs old and i'm on TRT now and i know its from the accutane. felt total normal before accutane and within 3 months of taking it, never been the same. but my face looks f*****g great!!!!. Don't waste your time with endos, been there done that, there useless........pm for a good doc.
Thanks. I PM'd you. How old were you when you took the Accutane?

[Testiclops]

Thanks everyone else. I'm probably going to go across the border to Michigan (there's an OD there who is particularly good with TRT and man stuff).

[beanball]

I also took Accutane before my woes started. I'm not 100% convinced that was it, but I'm hypopituitary. It was frustrating as hell getting this diagnosis here. I have stories that would make anyone cringe. I even saw a guy in Burlington that was supposed to be the best Canada has to offer in the field. He was horrible, very uneducated. It's sad when I know 10X more than him...

Anyways the doctor in Michigan is your answer. I travel across the border to see him. I have a long way to go but I'm on many of the replacement meds I need to be on now. And feeling so much better.

[clemenst]

I'm pretty sure the accutane does mess up something . otherwise its quite the timey for my body to take a shit dive well on it for me. Did the doc in michigan figure out if the accutane causes anything?

[beanball]

I'm pretty sure the accutane does mess up something . otherwise its quite the timey for my body to take a shit dive well on it for me. Did the doc in michigan figure out if the accutane causes anything?

No man. Rarely will you find a doctor that is interested in knowing 'how' you got into this condition. That's not a knock against this doctor. In fact it took me years to realize that I may never find out what happened to me. I can sit here and blame it on Accutane, and I have reason to believe it could be hereditary too. I know Accutane f'd me up in so many other ways and I "collapsed" right after my course, but all I care about today is feeling better. I was wasting too much time looking back on what could have been. I can tell you if you are interested - there's a site out there, very scientific - that basically pinpoints all of the different hormonal pathways accutane touches and subsequently buggers up. Not sure the policy on linking for this site, so try to find it or PM me.

[Testiclops]

I also took Accutane before my woes started. I'm not 100% convinced that was it, but I'm hypopituitary. It was frustrating as hell getting this diagnosis here. I have stories that would make anyone cringe. I even saw a guy in Burlington that was supposed to be the best Canada has to offer in the field. He was horrible, very uneducated. It's sad when I know 10X more than him...

Anyways the doctor in Michigan is your answer. I travel across the border to see him. I have a long way to go but I'm on many of the replacement meds I need to be on now. And feeling so much better.
Is it just gonadotropins or other hormones as well (thyroid, etc.)? Several factors can cause central hypogonadism (what I have as well). What are your prolactin and estradiol like?

I don't want to rush to TRT, which is pretty much a life long thing, if I can fix the source of the problem. Not sure if that's possible, though. And I feel pulled in the other direction too - I worry that I'll miss my window to see the Dr. from Michigan (who knows - he may retire) and most doctors, even endos, suck pretty hard when it comes to this issue.

If you don't mind me asking, what did the doctor from Michigan say when you asked him WHY it has happened to you (regarding Accutane, etc.)? Or was it just a rush to HRT/TRT?

[clemenst]

Ya if you could PM me the site thats would be good. I would liek to know if there is a way to restore all the hormone levels some how. i've tried nolvadex but that didn't work either.

[Testiclops]

Ya if you could PM me the site thats would be good. I would liek to know if there is a way to restore all the hormone levels some how. i've tried nolvadex but that didn't work either.
Not sure if there is any single answer (or if one even exists). It needs to be specific to your medical history. If you've evaulated thyroid/adrenals, maybe check out nutrient deficiencies, etc.

[Testiclops]

Ya if you could PM me the site thats would be good. I would liek to know if there is a way to restore all the hormone levels some how. i've tried nolvadex but that didn't work either.
How are you lh/fsh levels? Prolactin? Estradiol (specify if sensitive or ultra-sensitive)?

[clemenst]

estradiol-17 beta, (not sure if its senstive) 119 43-151
total prolactin , 16 2-18
LH 3 2-6
dhea-s 4.1 7.6-17.4
progesterone 3 less than 4
testosterone 18 8.4-28.7
bio t 6.9 2.7-19.2
sHBG 33 13-71
b12 320 198-615
cortisol am 614 170-720
cortisol pm (4pm) 267 170-720 (pM: up to one-half of patients AM value.)


At what prolactin level does it affect testosterone levels......are you okay as long as its in range or is mine high?

[beanball]

Dude your prolactin is high. Sorry for the question but are your nipples leaking at all?

Prolactin that high is damn sure to ruin your libido. But it signifies a potential adenoma as well. Have you been scoped yet, that is MRI (contrast/no contrast)?

[clemenst]

no MRI, my endo said that its not high. he had a paitent with a prolactin level of 600. he said that guy has a tumor. I figure he could just have a grapefruit sized one and i only have a pea sized one. I dunno, i have had my prolactin level checked a coupe of times, the lowest it has been is 7. Could a level of 7 to 16 be enough to surpress lh? I don;t see this endo for obvious reasons anymore. and i'm no lactating..lol

[beanball]

Endo's are by the Candian socialist book. If you're in "range", it doesn't matter if you're at the low end or high end, you're in the damn range.

But you can't tell me someone at the lowed end of the T range is still - without doubt - "normal". It bugs me to no end, you can't tell me someone at the higher end of the available T range won't be better off than the guy at the lower end. Instead, they won't do anything about it... they will kick you out the damn door.

Similar with your prolactin. Man bottom line it's at the higher end of the range. An endo ignoring that says volumes about endos. You have to be on your death bed for them to do anything and then even then they'll give you something that doesn't address the issue.

And stating a guy with a 600 prolacting as an example, man that's just a ****in' extreme case. But that's exactly what it takes for them to do anything I imagine.

Unless you just had sex right before that test, you need to get that prolactin down one way or another and chances are you may have a small adenoma. How is your vision? Any trouble in one out of the two eyes?

[clemenst]

no vision trouble, and didn't have sex before the test. Would it be worth going to see the doc in michigan?.....Do you think he will be able to get things nautral again?

[beanball]

no vision trouble, and didn't have sex before the test. Would it be worth going to see the doc in michigan?.....Do you think he will be able to get things nautral again?

Not sure... you might be better off in the short term to find someone here in Canada who is going to recognize that prolactin as high. It may be daunting, but you need an MRI I would suggest, which should come from this country. Otherwise to get that down you need an anti-prolactin and I don't have much experience on that subject.

[clemenst]

ya i don't think ill be able to get a doctor to beleive its high when in range. unless someone has a good doc to recommend. been on test E injections at 140mg a week and levels went to 48, 8.6-28. The blood was drawn three days after injection. Doc said to lower to 120mg. But i feel the same as i didn before trt. And my muscles are still sore and take forever to recover from exercise. i might consider going to michagan

[brawler32]

Hi Clemenst, there is a good clinic in Toronto, Calgary and Vancouver that deals with your kind of issues and it is covered by OHIP, PM me if you need more info.

[clemenst]

Does anyone know if mercury casued from eating like 4 to 7 cans of tuna week (plus i have 5 metal fillings in my teeth) can casue higher prolactin secretions?.......casue as i was thinking back, all my hormone issues started to happen when i started eating tuna. Casue the high prolactin would explain all my issues, and could affect my test levels, and also explain why i feel the same on trt with high t levels. I PM you'd for the doc, thanks!

[KoN]

Dr. Fred Hui, 421 Bloor Street.

He's a licensed MD who also sits on the licensing board of physicians in Ontario and he calls himself a 'alternative doctor'. I saw him today and specifically asked about hormone related issues and he was completely open to discussing them and prescribing injections/gel if necessary.

I specifically mentioned the spectrum and how you can be on the low range of normal and he basically agreed completely and said that most doctors aren't even thinking on that level.

Really smart guy and most important of all he is WILLING TO DISCUSS MANY OPTIONS instead of arrogantly preaching one gospel like I'm sure all of you guys had encountered.

He sent me for a full hormone test and I didn't even have to mention bioavailability, total, and free. He is on top of everything.

You have to pay to see him, though. 65 for consultation. He also gave me an epidural shot this afternoon into my lumbar. Perfect injection techinque.

[clemenst]

do you know if he will perscribe clomid to restart?

[KoN]

He's willing to discuss all sorts of things a regular doctor wouldn't even acknowledge. Go and present your evidence and at least you can be sure he'll listen.

[adam009999toronto]

I emailed dr Fred Hui. Never got a response. Maybe he doesn't accept patients anymore? I don't know. His website was extremely up to date on modern Testosterone + Adrenal Fatigue knowledge. I wish I could have a doctor like him.


I really need a new doctor near Thornhill/Markham. Tomorrow I am seeing my GP after receiving some catastrophically low T results.

May 25th 2015 blood test:
Testosterone Total: 2.3 nmol/L range: 8 - 32
SHBG 34 nmol/L range: 11-78
Testosterone, Bioavailable (calc): 1.0 nmol/L range: 4-17
Estradiol: <37 pmol/L range: 40-162


She is absolutely unwilling to prescribe me anything. Thus I will have to replace her but in the time being I need to give her a name of a specialist to refer me to. Does anyone have any suggestions? Beyond that I will need a new GP.

I want to ask my GP for pituitary MRI but I doubt she will allow it. She is worthless for anything beyond fungal cream honestly. Any specific tests I should prioritize? I want to ask for LH + FSH + Cortisol Am . Cortisol been low before.

Any advice or recommendations would be extremely appreciated.


And what was the name of that quality clinic in Toronto?

[steve_d]

Your GP shouldn't prescribe you anything for this either. I wouldn't be too upset about that. However, any good GP should be able to refer you to an endocrinologist. If you have to wait a couple months, I wouldn't worry about it either. Otherwise, just look up any endocrinologist in your area give your GP that name. I'm surprised you need to provide the name. Endocrinologist don't just deal with low test problems. There is a whole host of extremely common things that your GP would see on a daily basis that should probably be sent for an endocrinologist referral.

all things thyroid, pituitary, even things like menopause, infertility, and so on...

Having such drastically low test for no reason is not common, and it should be looked at by an endo.