Consultation with online clinic coming up - need advice
I’m putting my question at the top with more info below if you are interested.
I got my physical done and bloods drawn today and my initial consultation is coming up. They already told me they typically put people on Test, HCG and Anastrozole. I’ve heard others say they tried to put them on Clomid first. I’ve read about nasty sides with clomid but I guess the idea is to jumpstart your natural production or something? Not sure it’s worth going that route. The Anastrozole is the AI to keep estrogen levels in check so I get that. But why the HCG? I’m done having kids so not worried about that. I can see ball shrinkage kind of sucking but is it really that bad? On their website they claim it’s to keep your body producing test naturally which does sounds like it makes sense but what the F do I know. I read somewhere that HCG makes it harder to dial in the test and AI dosages but I can’t remember the source. What is your guy’s experience with HCG? I would have to order 90 days of stuff so I guess I could just order it and stop taking it if I want.
If anyone has ideas on what I should bring up in my consultation I’d appreciate it. Especially if you have worked with defy.
FYI I’m still not 100% on doing TRT but I’m leaning heavily that way since I’ve been feeling like shit for far too long.
I don’t know if you are familiar with DefyMedical but they are an online clinic that provides TRT and other treatments. They were recommended by a couple of different guys on r/testosterone for whatever that’s worth. They don’t take insurance and it’s costing me about $600 for the initial setup - $70 for the physical, $280 for labs and $250 for initial consultation.
The reason I’m going with these guys is because I had my GP order a testosterone lab for me a few weeks back that came back low.
Total: 256 [264-916]
Free: 7.4 [6.8-21.5]
I’m just below the typical cutoff so my doctor said I need to get a second test in a month. Well the labs he ordered were for just Test and nothing else. That leads me to believe he doesn’t know what he’s doing. He’s a good guy and I like going to him but I think this is above his pay grade. So I checked in with the local low-T center and they said they want to check Test, E2, and PSA. I asked about TSH, LH, etc and they said they don’t do that. Basically they just want you to pay $60 a week to go in and get a shot from them and I don’t think they really give a shit as long as they get their money.
So I reached out to Defy and they require the labs listed below and seem to know what they are doing. So far the process has been smooth but I can’t vouch for them yet.
Required Male Panel:
1. Comprehensive Metabolic Panel
2. CBC
3. Lipid Panel
4. Testosterone Free and Total
5. Estradiol Sensitive
6. DHEA-Sulfate *
7. *TSH
8. PSA
9. LH
10. Sex Hormone Binding Globulin *
11. *IGF-1
- Bookmark
- 0
- 0
I received my labs yesterday and I have consultation tomorrow afternoon. I've pasted some of the lab results below. I have pictures (scrubbed) with the full results but I'm not sure how to upload them. I have them uploaded to Imgur and can add the link if that's allowed here.
I want to get feedback on my results to see if there is anything the doctor should take note of.
Testosterone, Serum 274 [264-916] - prior test was 256
Free Testosterone(Direct) 8.4 [6.8-21.5] - prior test was 7.4
DHEA-Sulfate 277.0 [102.6-416.3]
TSH 1.810 [.450-4.500]
LH 3.1 [1.7-8.6]
PSA 0.5 [0.0-4.0]
IGF-1 252 [83-233] - HIGH
Estradiol, Sensitive 11.3 [8.0-35.0]
Sex Horm Binding Glob, Serum 19.2 [16.5-55.9]
Hematocrit 47.9 [37.5-51.0]
BUN 25 [6-24] - HIGH
Creatinine 0.98 [0.76-1.27]
BUN/Creatinine Ratio 26 [9-20] - HIGH
Albumin 4.8 [3.5-5.5]
Globulin, Total 2.1 [1.5-4.5]
A/G Ratio 2.3 [1.2-2.2] - HIGH
Bilirubin, Total 0.6 [0.0-1.2]
AnonAs far as these clinics go on the knowledge scale I would rank them as such; 1 being best.
1. Endo specializing in trt
2. Endo / urologist maybe.
3. Well versed and read GP
4. Trt clinic whose main goal is to justify a script and profit. At least they know what hcg, clomid and AIs are.
5. Below average GP who does not keep up. Example is a GP who says stuff like "we don't need an E2 test, we're treating testosterone" or simply follows the status quo.
This is my opinion on the knowledge they have. Some GPs are well versed, some are old bastards who don't read. Some Endos are shit, some urologists are very smart.
Any Dr. That defaults to trt without a restart attempt would warrant a second opinion on my book.
Alphamale500"Any Dr. That defaults to trt without a restart attempt would warrant a second opinion on my book."
I agree 100% with this statement you made! It may depend on what type of hypogonadism we're talking about, but I still like it!
+
You need to go back to your GP and get a referral to an endo doc.
The LEGITIMATE process is not overnight. the endo doc will try to find out the cause for low T. The path you are taking is not in your best interest. It is in the interest of those trying to line their pockets at your expense.
I at first went to my GP who started me on TRT without question. I felt I knew more than she did so I went to my sons Doc who was a TRT specialist. He tried Clomid therapy before putting me on TRT. This last round I went to a highly rated endo doc...
Before my endo doc put me on TRT he had me lose weight, take a sleep study, get an MRI and an ultrasound. About 9 months and 3 blood draws later, with Test levels at 135 (highest of the 3 blood tests) and no explanation for the low T (pituitary, sleep apnea, weight and diet, etc.) I was put on TRT. It was a pain in the ass to go through the process but I'm confident that all issues were explored and if a correctable problem was discovered a remedy would have been offered.
I only have a modest copay and I'm confident all avenues were explored before taking such a drastic, lifelong, maintenance program which TRT is.
These men's health clinics have their own interest in mind before yours. They don't care if they permanently mess you up and that's why insurance will not cover their services. Think about it, at your age, if they can keep your business for life you'll fork over $144,000 to those leeches.
Better to find a cause and a cure before settling on TRT. And far better to be on TRT that is covered by insurance and monitored by endo docs than snake oil salesmen
Alphamale500This is some of the most honest, informative information with the interest of the member in mind above all else, that I've ever seen written on here! Very nice Greg! And I had you figured for a grouch, lol! Jk!
I don’t like your answer because I’ve got this voice in my head saying the same thing and it’s not what I want to hear right now. I appreciate the direct feedback and I know you are looking out for me. I’m going off of the recommendation two Internet strangers which is pretty damn weak. I’ve already paid the money so I’m at least going to through with the consultation and feels these guys out. The worst case is I learn some new things and have labs and another opinion to bring back to my GP. I’m going to talk with my GP after meeting with these guys no matter what happens.
Do you feel like it was worth all the hassle and 9 extra months of feeling shitty for the peace of mind that you made the right decision. I mean 9 months feels like a long time right now. But I guess you are talking about a lifetime of needle sticks so maybe it’s not that long after all.
At that time I had my doubts and was so tempted to just self prescribe. However, what if removing a benign tumor next to my pituitary, or using a CPAP machine was all that was needed to keep me from decades of injections and monitoring? Not to mention, doing it your way costs an arm and a leg... and who knows, if I self prescribed and just went with UGL gear, it might literally cost me an arm or a leg.
Yes, it was worth it.
Don't be impetuous, look forward 20 or 30 years and make your decision from that perspective.
This is solid advice. Thanks man.
Based on your answer I have no idea why you asked for advice. You are just gonna do it. Wouldn't it be awesome to put yourself on trt just to find out later on it wasnt the issue?. So you feel lazy and have low libido and you want a hurry up fast fix. I lived with low t for a whole 3 years until I got off my ass and went to the doc. He then ran tests and I was at 200. Unbelievably he made me try clomid, lose weight, sleep study for my apnea, full blood panel, and then made me wait 6 months. What an ass! How dare he make me suffer so much for a whole 6 more months. After all that I was put on trt.
Go get your easy fix since you think it's so cool to inject yourself for the rest of your life, I bet you also think it's a free pass to run major cycles for 8 months at a time cuz fuck all you got a free pass. Do shit the right way and see a real fkn doc not a wellness clinic that can't wait to charge you 300.00 for a 5ml bottle of cyp.
Hcg would be cycled, or bolused, 1 to 2 times per year, after your estradiol and test level gets worked out and maintained for that Lipid Panel up top you posted.
Do some LH/FSH research and find out what that does for the body....
It may take 9 months to a year to get dialed in on your level. I doubt you'd need an AI in the beginning. But, everyone is different, that's the fun part!!
The HCG is supposed to stimulate LH and FSH production. I forget exactly how this works. The FSH mostly helps with making sperm and the LH is what stimulates your testes to make testosterone. The TRT causes your testes to stop making testosterone so they atrophy which is why your balls shrivel up. The HCG is used for fertility and to keep your
balls making T.
It’s interesting what you say about getting your estradiol and test levels worked out first. I am going to ask the doc about that because I don’t understand why we would throw a third variable into the mix if we don’t have to. I already have kids and don’t want more. I could live with the small testes problem, at least to start. This is worth discussing with the doc anyway.
Exogenous test administration shuts your HPTA down at 20 weeks. LH/FSH stops being produced. Not only can hcg be beneficial, but tamoxifen can too. It's not just what hcg does, it's what LH and FSH are responsible for after their production...LH helps insulate axons, dendrites, and helps hair and nail production, etc...research more
this is why a lipid panel is important, while on trt. When your body doesn't produce enough estrogen, or you're in an over production secondary to too high a dose, and the exogenous test dose isn't correct, your BW, as well as your body, will tell you something isn't right. At that point, you will need to address the signs and symptoms. It's complex and yes you would benefit from an Endo consult. 
Anon60$ a week is nuts!
I run hcg every now and then (not trt patient) to plump the sex prunes back up and unload like a bull.
I do notice a pain? Maybe? In the plumbing while everything is firing back up. Not like a knife, but just an odd feeling..?
For 60 dollars you could have 20 weeks worth of ugl test.
Make sure you read the rules fyi. No source talk in the open forums, no payment methods, locations, nothing. There are pages on here called source discussion where that's ok.
Shit I didn't realize I couldn't discuss that here. Should I just delete the post and re-do with just my questions?
I think your good just take defy outta the title
AnonGood idea, might encourage someone who's no where near the need...
Maybe...idk :/
AnonNo you're fine, just don't ask here about where you can buy anything illegally.
RustyhookerSounds a long like a doc in the box or rejuvination clinic.
I hope not because they are so damn expensive. My hope is that they are good at this because they do it all the time. But I posted the question because I don't really trust them yet.
You can't trust anyone these days. Eroids holds the people here accountable, too. We, as a group, come to together for the common good. You're on the right site. Start your research, now, then determine if you think it's a good thing to shut down your HPTA. Risks vs. Benefits???!! Only you know what's right for you!!
AnonThey just write scripts and charge out the ass. Some of them sell ai's individually for a couple dollars..sccaaammmm
Let the Doc make the decisions as to what to re HCG etc.