T Nation

Initial Appt. with Defy Medial Monday. What to Expect?

I was wondering what to expect. I’m a 52 year old male that has been suffering low libido, brain fog and weakness plus a sharp drop off in exercise tolerance/results in the last 4 years. My total T levels
had been hovering around mid 300’s last few years and my free T has been about 1 or 2 points above the bottom of the reference range as well. Do they usually go straight to suggesting supplementation or boosting natural production? Or does it depend on the individual and their circumstances/life situation etc…?

Thanks!

Given your age I think I’d skip over a restart or what you called it and go right to TRT which knowing them will consist of a protocol along the lines of 60mg E3.5D, 500iu 3.5D, and they’ll probably give you .125mg Anastrozole with PRN instructions. Though it’s highly individualized their stuff tends to fall in that range and given your numbers I would expect them to prescribe very closely to that.

Thanks for the input. I’m that needy early phase with this looking for support/reassurance. I’ll probably make only one more thread which will be a log of progress then I’ll stop “spamming”, lol. I’m sure I’m pretty typical of the guys that come through this forum.

I am recycling this thread to keep the clutter down if the mods don’t mind. I had a call today with Defy and have my starting plan:

-Testosterone Cyp 200 mg/ml –inject 0.35 ml IM/SQ twice weekly (25G, 5/8” needle/ (1cc syringe Luer only)

-HCG 500 iu inject SQ twice weekly to reverse/prevent testicular atrophy

-Anastrozole 0.125mg twice weekly – h/o elevated E2, titrate on follow-up

-DHEA 25 mg at bedtime

-Vitamin D3 5000 iu daily

-Fish oil 3-4 g daily for HDL support

F/U in 3 months with full labs with IGF- 1, FT3

He has suggested the possibility of raising my T3 which I’m not averse to since I have some symptoms to support the notion that my thyroid is not optimal, though clinically “normal”. I was okay with that but asked if we could try to stabilize on TRT first. He was more than okay. I was actually open to doing it either way but all my experience in everything in life including my job is that when you are troubleshooting it’s best to work with one variable at at time.

I’ll keep everyone posted.

I sort of get their protocol but idk. Your dhea-s is fine so why the supplement.

Your thyroid seems fine too. Your over 50 and it looks like they will put you over the ranges. Starting 200 mg a week. Dhea . HCG. Yeah you will probably need the AI.
Am just not in love with the protocol. Imo.

So they have you decide im or subq? What’s their thoughts on this.

Its 140 mg/week Test C broken up into 2 intra-muscular shots. He did not mention the option for the T being subq.

The hcg is subq.

We will revisit everything in 90.

I’m okay with everything. The DHEA supplement was not something I was expecting but I will give it a try.

What I wanted to know was if anyone else has addressed possible thyroid issues from the beginning in addition to T levels or if they looked at one issue at a time. I also wanted to know peoples general feelings on going after that at all absent really glaring thyroid issues.

Your thyroid is probably fine. I would wait after a few months to see how your thyroid is.

I got my stuff today and started. I am okay with being an HRT guy. I have a lot of worries about my mental/brain health so taking hormones is nothing in big picture. Like @systemlord I used benzos and a benzo like drug, for a period of 7 years, about 6 years on each to deal with chronic groin pain from my vasectomy. I feel like it screwed up my brain a little bit. I just quit Baclofen 2 1/2 months ago. If you dont have your mind you dont have anything. I’m a little concerned I’m in the early stages of a neuro degenerative process. Could just be adjusting to being off Baclofen.

So I mixed up my HCG and did 2 shots and took my Anastrozole.

Good to go.

I’ll use this thread as my journal.

Thanks for everyone’s support.

I just had my consult with Defy last week and asked about IM vs SQ and Dr Calkins said he didn’t care which method I used and that in his opinion neither route was superior, just different.

He said that by going sq it just gives me more sites which to cycle through

Protocol seems almost identical

Thanks for getting back to me.