What Do You Think of This Protocol? First Time TRT with DefyMedical

Just finished my consult with Dr. Calkins today, here is his plan.


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

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

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

Begin Vitamin D3 5000 iu daily

Begin Fish oil 3-4 g daily for HDL support

F/U in 3 months with full labs

Dr Calkins

is 500iu of HCG twice a week too much?

He said to inject Test and HCG at the same time and day, and to take AI within 15 minutes of injection.

I’ve added labs below.

It will take time for estrogen to become elevated if at all, so don’t start out on the AI. Your estrogen may become high for a short period of time as your levels swing day to day, try not to tap out and go for the AI and let things settle.

One way to know if AI dose is too high is headaches or pain behind the eyes followed by excess yawning, if this happens stop use of the AI.

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How old r u?

Did you try other stuff like diet? Weight ?
I wonder when your estradiol at 33 before trt if you are obese.

Your free t is decent.

You go to a trt clinic they will give you testosterone.

Your cholesterol low.

Also what’s your prolactin?

They will give you what makes a man a man, more than sick care providers denying men the right to behave like men is far worse and shameful.

We see everyday men scoring low normal levels and being told they are normal, men who are less of a man.

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Numbers were a bit blurry, but it looked like TT=578, and FT=17.6. I agree with you that these numbers could be improved to good numbers with weight loss, and other lifestyle improvements.

I would not go on TRT with these numbers. If those numbers were TT<400, FT<10, sure TRT may be warranted.

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Be aware OP Free T isn’t high normal and is actually lower do to his age, 25 pg/mL would be high normal for him, 17 pg/mL is below mid-range which is why he was approved for TRT.

This is one lab test. One. He is Natty.

Should get another lab done after a good night sleep.

You are generalizing ops case. We need more details. Since his numbers are not LOW he probably should make sure he doesn’t have underlying disease.

Did he take this lab at 5pm when these levels would be awesome? We don’t know.

And if op is obese with these numbers…trt will not help without side affects

It says on the top that it was taken at 2:22 pm.

a 10% drop is reasonable in that amount of time. That would put his morning TT at 642, and FT at 19.5.

If I had those numbers, I would not consider TRT.

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You are pissing up a rope systemlord this boy should not have been put on TRT with those natty numbers. Dr C is my doc and I can’t believe he did this. There’s got to be more to this story we don’t know.

His symptoms can’t be ignored and have gone on long enough to suggest a problem, sick care would turn this poor fellow away and offer him no help. They would say he’s normal and it’s all in his head.

Thank God for these clinics.

I agree, something only with training and experience could see, that’s why I’m giving Defy Medical the benefit of the doubt.

A 40 year old man ranges are 6.8-21.5 so 17 may not seem all that bad, his ranges do to being younger are higher and cap at 26.5 pg/mL, he’s well below high normal and about midrange or lower if we take his age into account.

Range is 9.3-26.5, so 17 puts him nowhere close to high normal.

Wtf are you talking about?

Op gave us NO personal details.
NO symptoms. Just labs. And you pushing trt with decent testosterone levels…

Am surprised you didn’t tell him to inject EOD yet?

He has full blown symptoms. Having had gyno suggest hormonal imbalances taking place, his levels could be bouncing around all over the place labs don’t always show well. I’m sure Defy doctors are used to seeing this after seeing 20,000+ patients.

My bad. Still needs to check stuff out with Those levels.

@sanelb you really should not have started a new thread. You make it hard for us guys that are not on here 23 hours a day. And you will get less help.

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I always make a habit of clicking on the username tabs to see if a duplicate thread exists, I’m guilty of getting mixed up myself.

I don’t understand, why are so many people against me going on TRT? You’re all on it, and I’ve browsed the forums; you’re happier, you have more energy, you’re making progress in the gym, you’re waking up with erections, your libido improved, you feel like a man for once in your life. Why does it matter if i’m 28? There are guys on here that started at 20.

I’ve tried and exhausted all other options, and I think I should give TRT a try, I understand it’s a lifelong commitment and I understand that I may become infertile, but I don’t care for that.

I’m 6’0 180ish lbs, low body fat, I eat clean, I’ve had my testicles examined for abnormalities.
I haven’t had a morning erection in years, I’ve been tested for sleep apnea, I went to other doctors, they did full panels including thyroid, which all came back normal. When I haven’t had a morning erection since age 24, I feel more fatigued than I did, I burn out faster in the gym with a few workouts, but didn’t when I was younger, something is off.

Hell, here some more labs, some of you were saying that my morning test would be higher, but that’s not the case.

Total is 459 for T, that’s the T of a 60+ year old man

And what if I need higher than 600 to feel normal? I’ve read that everyone feels different, and some people need higher T to actually feel that way.

459 is low. 578 at 2:22 pm is not that low. As someone above said, there seems to be something missing.

I have symptoms at the levels you just shown, but that is about as high as I have tested. I think I tested at 470 (after a deload week), 379 (during a regular training week), 390 (again during a regular training week), and 530 (on HCG protocol).

I guess your lesson is not to start multiple threads as your old lab work showed more of a need for TRT, but your new blood work looks pretty good IMO, but things fluctuate. You are normally probably somewhere in-between.

I support you man! As long as you went to endocrinologist to check you as well even if they may not treat.
Keep us posted.

I am with this guy ^