T Nation

Who Has Left Defy?

Been thinking Of switching to Dr Rotman here in NYC. I’ve seen him before but he wasn’t quite Dr Saya, but he’s damn close. That said, between the ups and downs of TRT, combined with pituitary tumor complications, I’m starting to see some value in someone I could see more often if needed.

Would also be nice to get insurance coverage and not have to deal with Defy’s “other” staff.

Anyone else leave and find satisfaction elsewhere?

I was a Defy patient until recently. I mainly used Defy for access to HCG and an AI…I get my Test from my hematologist and is covered by insurance. I no longer take the HCG or AI and after two years have discontinued my relationship with Defy. No issues with them, just unnecessary costs. My Hematologist is very up to speed and on TRT himself.

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Ironically my only issue with Dr Rotman is his insistence on HCG. I’ve found this to be common with my tumor doctors too, minus one (“oh so you use TRT like birth control, I like that!”). The rest freak out that I’m going to be sterile and refuse to acknowledge that HCG might make me feel worse.

Yea defy was all about the HCG as well…I was a good trooper and followed direction for 2 years. Multiple high E2 symptoms , acne, water weight…but you have to keep those pathways back filled! I broke away and want to reassess. Without it and I feel great so far. It is early and time will tell. If it was worth taking I can always go back. Not today!

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Have you checked with dr Rob Komimiarek(maybe I mistake his name)?

He is a great doctor, I believe can help you and his annual price is very affordable. You need to make one physical visit to his office at the beginning.

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I disagree with this comment. I too am with Defy. Dr Saya asked if I planned on having any more kids. I said no, and then he said that i dont need to take HCG. it was as simple as that. Nothing else was ever said about HCG…not a thing. At one time they might have been all about HCG, but not now.


Yea, but if I leave Defy, it’s so I can have someone local I can see more often/more easily. Not someone else states away!

Yea Dr Saya crossed HCG off the list for me the moment I said it didn’t make me feel well.

Side note @vonko1988, 48 hours after HCG injection I’m feeling normal again.

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This was my experience as well, Dr. Saya even stated I could revisit HCG if I did become interested in fertility.


I asked him about fertility (my tumor doctors were super concerned) and he said there are many other options if it came down to it. FSH injections and other things. So I’m not worried.

Same. I really hate to pay for FSH but it sure seems like a direct route to sperm’ville when needed.

Here’s one of my struggles with Defy in a nutshell:

Called them and mentioned my recent low libido issues and asked what I should do. Got one of the nurses.

Super nice, but even after explaining that my tumor dr asked me to lower my T dose, then I raised it back up, all they could really suggest was to take my T dose to the maximum I’m prescribed (go from 150mg to 200). I asked about doing updated bloodwork and it was suggested I wait a few weeks (reasonable). And then got recommended trimix…when libido is my problem.

Just stuff like that feels so far from talking to Dr Saya, and I feel would’ve gone better with either him or another dr in person.

Not my experience…As of my Last paid consult a couple of months ago, it was highly recommended for me to stay with the HCG, just lower the dose to mitigate the sides…“backfilling the pathways” was the reason. I guess it depends on which doc or NP you visit with.

Can someone explain to me what “back filling the pathways” actually means? I’ve seen that a few places.

Make up for no longer producing LH i believe, theres not really been anything proven that I’m aware of.

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It’s something Dr Crisler believed a while back but pretty sure he changed his mind on it before he died.

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Better have somebody away that will pay you attention and knows what he is doing instead of some clueless local endo. The advise Ive received from US doctors I spoke to thousands miles away was more worthy than anything I receive here.

Why would you need him to be around you?

With dr Rob you communicate over video, so If you provide him the necessary labs he can help you as needed

Better find a really good doctor, be consistent with him and follow only his advise. Taking advise from 100 places will not work for you at all

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It definitely affects something but after seeing my DHEA fine without HCG, I lost a lot of belief in this pathway stuff too

Thing is, there are really good doctors in NY. If I lived in the middle of the US somewhere, I wouldn’t hesitate at all. But being able to meet with someone in person definitely has its perks.

I’m just gonna try Defy’s “raise your dose back to 200” advice and see how it goes first. Put a little trust in their experience.

Is there a reason why you have to use Defy’s pharmacy? Can’t the doctors at Defy send in the Rx into your local pharmacy to get filled?