T Nation

My TRT Journey Starts Now


I completey agree and I’m not condoning a blanket approach to TRT, but can you imagine how difficult it must be to come up with a generic starting point when you treat 10’s of thousands of patients, with a good majority of them being people that they have not, nor will they ever meet?

I’m not a dr, but I would imagine that if I were tasked with that responsibility, I would start with whatever has worked for most in my experience, and then re assess in 6-8 weeks, and then make adjustments form there…which is exactly how I understand Defy to handle protocols over time.


who do you go to? endo? i know you are a bit against anti aging. or atleast what ive seen around here


No, I cannot imagine. I do not believe this practice model is best practice and it is not in the best interest of the patient. Working with a doctor I had not met makes no sense to me.


He’d guys are all pointing you right. Problem is that with high shbg it doesn’t mean your not going to convert t to free t and e2. Some people have high shbg but they convert with no problem. System lord calls it sticky or not sticky shbg.

160 is a good dose to start. It might get you to where your st now. Your shbg will drop with trt protocols since I hear or have heard numerous times that chlorlmid raises the shbg.

Dude for real just ditch the ai. Don’t go off numbers. Sure it gets to 49 but do you get the symptoms? If not why worry about it.

Your lucky that you only need .1 that’s not bad compared to .5 or 1.0 some folks take weekly.


They did this to two other guys. There getting greedy man. They jsut want more money. Jsut spoke to a friend tonight whose on all kinds of videos and talks to docs all the time. He said that’s what they do to make money. They force all these different meds. When they actually care to optimize they drop everything and use only cypionate for a couple months to form a baseline. Form there they will add hcg only if client wishes.

They don’t suggest hcg for anyone. Too many sides and issues form what I’ve heard. Jsut watched a video earlier that discussed this. Watch:

I believe midway through they discuss the hcg question.


No arguments here lol, and I can’t speak for everyone but in my case, the better option was going with Defy. I had a choice between a local PA here in Montana who thought that I was crazy when I asked for E2 testing, or going with an operation that does HRT exclusively and gave me the impression that their main interest was optimizing me over over time. Was a no brainer for me.


Yes it’s hard for most of us . I’m on 2nd month with another clinic and although there legit for a telemedicine clinic, I don’t like not having a doctor to answer my questions. The guys are jsut not equipped to give proper advice. They don’t look at my problems like a doc would and give me a true solution.

I’m scheduling an appointment with a doc Chattanooga and will fly out there to meet him end of month. After that he can prescribe to me, but he’s awesome. The guy actually cares and wants to help: more importantly he’s on it himself and wouldn’t prescribe anything he wouldn’t take.

It is more expensive but I would rather like to know it’s done right not test and re test till it fits.


And just for the record, I personally was advised once during the consultation on what the typical starting point was (HCG + AI) with their TRT approach. I made the statement that I wasn’t interested in either of those and that I wanted to stay with Test Cyp only. The others were not mentioned again in the entire consult. Not once did I feel pressured or that the dr was being “adamant” concerning the HCG / AI angle. Not minimizing anyone else’s experience, just sharing mine for diversity.


If this is the recommendation then it should be because the doctor believes this protocol is in the best interest of the patient. The fact that they did not “pressure” you is concerning. It’s good to involve the patient in the decision making process, but the doctor should take the time to educate you as to why it is important to follow the recommended protocol.

I assume they asked why you did not want the hCG and AI. If they didn’t ask, they should have. If they asked why you did not want hCG and an AI they should have explained to you why they think you should take it. From there you can make an informed decision.

It looks to me like they will just sell you whatever they can.


Sounds like a wise move. Good luck.


He did ask, but I was the one that probably came across as adamant in my case. I told him that an AI for me was a last resort and that, since I had already been on TRT for long enough to know that I wasn’t having issues with atrophy, and that I have had a vasectomy, so therefore no need to even think about fertility, he agreed that HCG was not necessary for me and that we will see where the labs fall on my follow up.


i havent read much about AI but why do people run away too much from it? seems like another trt talk “trt is only last resort” now i constantly see “ai is last resort”


Because it is being found time and again that higher E2 levels are not bad if they are within a good ratio to Free T. A lot of guys take an AI chasing a specific E2 number and wind up crashing it. I don’t know from experience, but I have read that crashed E2 is ten times worse than high E2.


got it memorized. thanks!



Watch the video. It’s health related. Ai creates massive problems with bone density, heart problems and the less estrogen the more problems. So many guys are given ai like it’s candy. Some are given cancer dosage. Long term usage is harmful.

They made a good point. Young men have heart attacks, but woman do not. Same with older woman: why? Doc said it’s becsuse they have estrogen. Men and woman share all the same organs and skeletal + cns systems except our reproductive system.

Dr Nichols talks about it.

I suggest you start researching and staying on top of trt information through sites like tot revolution. Who knows more can change in another year and you don’t want to miss them :slight_smile:


thanks a lot. it’s an interesting hormone that most endo don’t even check when treating males (from experience and from what i’ve seen in this forum). All i can say is low e2 is a nightmare. literally.


thanks mate. doctors should start reading this forum information instead of the books they read in medicine school.


This is becoming more and more common across the field. I work in Health Care and the Telehealth market is growing like crazy.


Actually I’d work with dr Nichols or someone of his caliber over the phone. I know he’s good and I trust his experience … the problem is not telemedicine it’s the quacks who don’t work closely with the clients . Instead they pick up hundreds of customers to make the cash. Instead of providing a quality service and charging more.

That’s how I run my business qualify over quantity. I charge double or triple but there is a market for it. Especially when people realize how badly they need the experts.