1st Defy Consult & Recommended Protocol

[MaxP]

60 year old male in California and have tried TRT in the past with just Testosterone prescribed by PCP which I stopped 3-4 months ago.
Today I had my Initial consult with Defy and was recommended the following protocol for the next 3 months.

1. Testosterone Cypionate 200 mg/ml – Inject 0.35ml IM/SQ (70mg) twice weekly
2. HCG (Pregnyl) - Inject 500iu (0.50ml) SQ twice weekly to reverse/prevent testicular atrophy.
3. Begin Anastrozole 0.125mg - Take 1 by mouth twice weekly IF high Estrogen symptoms present.
3. DHEA 25mg - Take 1 by mouth every night.

Follow Up in 3 months with same full labs and adding FT3 & RT3
I can request a consult after a month if nothing changes or I have any issues with new protocol.

My PCP prescribes my Cypionate 200 mg/ml and hopefully she will prescribe the HCG so my insurance can fill it.

1. The DHEA 25mg is OTC or from Defy's pharmacy (APS)........I would appreciate any recommendations for best OTC brand etc for this.

2. I thought he wanted me to start the Anastrozole now but consultation summary states "Begin Anastrozole 0.125mg IF high Estrogen symptoms present" so I probably have clarify with Defy.
What symptoms should I watch out for if they only want me to take it then?
If I need to take it I will have to get from Defy's pharmacy (APS) as local pharmacy's here in SoCal only carry 1mg........Any other options?

I started today with the first 70mg Cypionate dose and will start the other meds as soon as I get them.
Feel pretty good with how the consult went and have no issues trying this protocol and working with Defy.
i've attached my lab work from last month.

 

[Phil Goodman]

My initial thoughts would be


1.) you may be able to get by with less than 140 weekly, but that’s a pretty reasonable starting dose. If you do decide to take less than that it would result in slow buildup of an emergency supply, which imo everyone should have an emergency supply of all medications.

2.) I recommend waiting at least six weeks to start HCG. For one your body is still producing testosterone and will for at least a little while. Might as well get the honeymoon phase with just testosterone before adding anything else. Secondly, it’s easier to dial in one thing at a time, so getting settled with test before adding HCG would be ideal. And again, if your protocol ends up being less than 1,000/week you could build up an emergency supply

3.) it’s very unlikely that you’ll need an AI. And don’t be tempted to attribute every negative side effect to high E2. It may take a while for your body adjust, so let it settle in for quite a while before considering the AI.

4.) I just order my DHEA directly from Life Extension. And like with others above, I’d hold off on adding it. Wait until you’re settled in with others. For example I’m pretty sensitive to DHEA and it amps me up at just moderate doses(even my Dr. at Defy who is awesome says it’s a strange case with me in that regard). If I’d started that right out the gate with test I would’ve almost certainly attributed those side effects to the test because it would seem much more likely. But since I dialed in one thing at a time I know for sure how the DHEA affects me at various doses. FYI I ended up settling at 1/4 of a 25 mg pill daily, so that saves money and is a much lower effective dose than most.




But again that’s just my take on it, and how you approach your health is completely up to you.