Bingo. Furthermore. If you are the uneducated one… They give you to START : t3 , hcg, ai, t, dhea, preg, and sometimes a peptide if igf lower…Let me see you dial that shit in.
greed is very powerful
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Ok. This has been terrifying but eye opening and great. I think I am going to ask for one more consult with someone else on their team before I start. I’m going to come in adamant at this time but would really would love your opinions on what you think is a smart start given my numbers (including my high SHBG, albeit likely Clomid induced). I’d rather do this upfront and get their buy in then just make decisions on my own and have them get pissed and drop me in 2 months.
Again, here’s what was recommended:
- 80mg test twice per week
- 500iu HCG twice per week
- 0.1mg Anastrozole twice per week
- 25mg DHEA nightly
What does everyone think about me going back with asking to start at:
- 60mg test twice per week
- No HCG (have kids and getting vasectomy)
- 0.1mg Anastrozole once per week or not at all
- No DHEA
Thoughts? Thanks. You guys are amazing.
If they drop you… fuck em. That would be unprofessional and you would not want to be with then anyway if they want to drop you.
I like your suggested protocol. Am sure if you tell them I would like to try this, are you ok with this? They would agree. I would tell them 120 a week but take 100 to start. It will help you Limit that initial jump on e2. Then you have the extra t if you choose to go up higher than 100. We are all different. 100 takes me to about 700-750 total t.
But with defy it may not matter if you say 100 then want more. They would more then love to give you more. BTW no ai to start.
Do that protocol for 2 full months. Then see how you feel and do basic lab
Estradiol
Free t
Total t
Shbg
Cbc
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I don’t think telemedicine is necessarily a bad thing. I do think the way these internet T mills go about is not ideal and possibly even illegal.
I personally know some who use it. They call an 800 number several states away. They’re told to order their own lab work and to go to a Walgreen’s or CVS and get a physical exam, “like a pre-employment or sports” physical. They fax the results to the “clinic” and get a phone call, next day scripts arrive via FedEx. A lot of scripts.
The doctor did not even examine the patient, instead they took another practitioner’s exam. Nothing at all against the exam doctor, or PA, or NP, but if someone contacts me over the phone and tells me they have hypertension, produces (via a fax) a piece of paper from another doctor with a BP reading, and requests losartan, I’m not giving it to them. How do you know any of that information is accurate? I’m checking their blood pressure myself.
I can see the telemedicine thing AFTER the doctor has personally had a face to face consultation with the patient. In fact, most states require a face to face meeting prior to telemedicine. Also, most states require the doctor to be licensed in the state in which the patient resides. Traveling and seeing the doctor first is fine as the phone follow-ups are essentially an extension of the initial visit in the doctor’s home state, in which they are licensed.
I can see these online clinics being shut down at some point. The Feds are probably watching them, waiting for them to get big enough for it to be worthwhile for them to swoop in and shut them down, and hit them with a heavy fine. Follow the green.
Agreed, I’ve watched him on several videos and he comes across very well. As a doctor, he should insist on seeing the patient, and he should follow state practice laws. In my opinion, the problem is telemedicine practiced illegally.
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Couldn’t agree more. You do your homework, they will listen to you. I have had a great experience with Defy so far.
They wanted to start me on an A.I., so I acquiesced. When I later read up and asked to go off and switch to just Test/HCG, they were OK with it because the protocol I wanted made sense. They will work with you, as long as you’re reasonable.
Am sure defy is probably a good practice. BUT when guys say switch to defy they are the best. I just don’t see that. They should treat you similar whether you are informed or not. Based on symptoms and labs and weight.
So if you are not informed you agree to ai HCG etc but if you say 1 thing about it because you are informed they back off.
Just doesn’t seem right.
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Thanks so much. And to be sure, looks like you feel it’s a good idea to drop HCG for now? As I said in another thread, I want to keep this as simple as possible. Also, I battled terrible migraines through puberty and based on the research I’ve done in HCG, I feel like it could bring that right back for me (though Clomid didn’t).
I like it.
120mg a week sounds reasonable. The vast majority of guys do fine with weekly dosing, but nothing wrong with twice weekly.
I would not start with anastrozole in your situation. I can perhaps see it with an obese guy, already emotional, coming in with higher E2 prior to starting, but that is not you.
I would drop HCG. You need to know how it is with basically just t.
Ever try magnesium glycinate for headache etc.
I was about to post exactly that. Yes, looks like the sell you, but if you are “informed” then they’ll sell what the can. Pity the poor guy who is not up to speed on TRT.
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Nice that they let you be your own doctor, especially since you know your stuff, not like the typical guy just looking for help. My issue is the average patient is not as knowledgeable as you are.
Am about to lighten things up in here…ready.
The best think for my dick is not defy…
It’s a 
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Couldn’t agree more. And that gets me 90% there without TRT (just noticing minor decline as SHBG climbs). Not trying to fuck that up.
Well I was fortunate enough that they stopped by age 18. Was just through puberty. Going to see if I can speak to a nurse today just so they can note it in my file and trying to be respectful of them.
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not obese (clear upper abs), but certainly emotional. Then again, so was my grandfather, my mom, etc. Only time I wasn’t emotional was on an SSRI because I was a fucking zombie.
Yeah, I understand it. Perfectly reasonable point. I think for most guys who are already on forums, though (implying they know a few things), Defy is a good option. They also have a relatively formal insurance process, so I’ve been able to have some of my care reimbursed – which is huge! I don’t know if other telemedicine clinics offer similar services, but it’s been a beautiful arrangement for me. I basically pay for 50%.
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I could get on board with this thought, but you have to apply that across the entire board though right? The same thing has applies to the clueless uniformed guy who goes to his PC and says I feel like shit. Can’t sleep and have anxiety. That’s a face to face consult and what does he get? Fucking Xanax, Cialis, and sleeping pill. This guys gets fucked for YEARS because he did not educate himself and insist on getting the proper hormone bloodwork done. Even MORE, if this guy is still uneducated but knows enough to ask for the proper bloodwork, they start him on a 200mg every 2 weeks protocol. That’s fucking torture!
So what’s worse? Having a protocol not work for 6 weeks and then having a competent doctor work with you over the phone to adjust it and help you through it, or having a clueless PC dr look at you in the face every 6 weeks and say, “I told you that testosterone was dangerous! You’re lucky you didn’t get cancer. Now stop that shit and let’s get some Xanax going for you!”
It’s catch 22. Bottom line, in today’s world you better be informed.
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Ok. Just scheduled another quick consult for Monday and lowering to 50 or 60mg twice per week, no HCG, no AI, no DHEA. I can’t imagine that they’re going to fight me on wanting to take a more conservative approach.
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Agreed, in all areas of health, be informed. But, there are some differences here. The PCP is going to insist on his approach, because he thinks that is best for you. We think he is wrong (separate issue), but none the less he is doing what he thinks is right, and he honestly believes he is.
The online T mill will sell you what they can. If they really believe the AI is important to your health they should insist on it. Same with hCG.
Right again, I’d opt for a less than perfect TRT protocol. Lesser of evils. Two wrongs don’t make a right.
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Good call. Good luck.