I did. I was a little peeved to pay $30 for it considering the delay, but in the end I'd rather get started on the AI and I wasn't in the mood to argue about who should cover the shipping.
Clomid (and maybe more) with Defy
- Thread starter Esq
- Start date
I did. I was a little peeved to pay $30 for it considering the delay, but in the end I'd rather get started on the AI and I wasn't in the mood to argue about who should cover the shipping.
Dr Justin Saya MD
Moderator
The delay is unfortunate and atypical. We've had a key medical member out for emergency surgery, but other staff is working their behinds off to keep up.
Just wanted to check in here for a quick update. As noted above, anastrozole was ordered Tuesday with overnight shipping, but as of today (Thursday) it still hasn't arrived and I haven't reveived any shipping info from the pharmacy. I'm not optimistic it will arrive this week at all.
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It might just be in my head after seeing the numbers last Friday, but I feel like I'm having some classic high e2 symptoms the past few days. Excessive bloating (like pants that fit comfortably a week ago barely buttoning), swollen/puffy nipples, moodiness, and hot flashes and night sweats.
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My fingers are crossed it arrives tomorrow so I can try to allieviate some of this soon. The bloating is the worst of all. Just a terrible feeling.
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It might just be in my head after seeing the numbers last Friday, but I feel like I'm having some classic high e2 symptoms the past few days. Excessive bloating (like pants that fit comfortably a week ago barely buttoning), swollen/puffy nipples, moodiness, and hot flashes and night sweats.
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My fingers are crossed it arrives tomorrow so I can try to allieviate some of this soon. The bloating is the worst of all. Just a terrible feeling.
CoastWatcher
Moderator
I'm not sure. My clomid has always come from Hallandale, but the Defy receipt never indicates the pharmacy and I haven't received tracking from the pharmacy. I did email Defy early this afternoon (directed to the guy who put the order through Tuesday) asking for a status update, but so far I haven't heard back. I suspect I'm SOL until Monday at least.
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I'll add that the Defy order confirmation always notes to "allow the pharmacy 24 to 72 hours to compound your medications," so it may be that the "overnight shipping" is overnight from whenever the pharmacy gets around to processing the order. It's not yet been 72 hours. I just had some hope that based on my struggles and the delay even getting the prescription processed in the first place (and paying $30 to have $18 of medication shipped), it would have arrived by now.
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I've been pleased with my Defy experience so far overall, but this past week hasn't been fun. Shit happens, I get it, but it doesn't make me feel any better.
Somehow I missed this post. Yes, it does seem to be a somewhat regular occurrence. My sensitive estradiol numbers have more than doubled from low 30s to almost 70 since starting clomid, and I wonder how much of the return to baseline (or worse) is eleveated estradiol. I hope to get those levels back into the 30-40 range with anatarozole (when it arrives) and see a corresponding improvement in how I feel.
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Have you had labs done since you stopped feeling that early clomid boost?
johndoesmith
Member
In my experience, shipping only applies after the pharmacy ships the medication. How else could it be?
Keep in mind that the delay you experienced was probably due to the holiday, you emailed on saturday, so the next business day is Monday. Saturday and sunday don't count, as they aren't considered business days.
So yeah I get it man, trust me, I was so damned anxious for my first delivery to arrive. I ordered on a Tuesday and got it on a Monday.
I hear everything you're saying, and don't disagree. I have come to realize that this is one of the downsides of telemedicine (specifically telemedicine that requires a patient to use particular compounding pharmacies). If I go see my doctor locally, and he calls in a prescription, I can go pick it up that day. If I use a telemedicine doctor, and that doctor sends me a written prescription, I can take it to a local pharmacy and pick the meds up that day. In neither case do I have to wait as much as 72 hours for the pharmacy to get it ready. With Defy, I'm at the mercy of the the compounding pharmacies they use. I knew that from the start, so it is what it is.
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Maybe the issue is more with the pharmacies. Three full business days to process a prescription for about 10 anastrozole pills is a little ridiculous. Look, for both of my clomid orders I was patient. It took 5-7 days in both cases for the meds to arrive, and I had no complaints about the wait. It just seems like there should be a mechanism for Defy to have the pharmacy expedite processing and compounding when meds necessary to control side effects are needed quickly.
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In any event, Defy got back to me this morning. They confirmed with the pharmacy that the meds would be shipped today (so, it took the full 72 hours) and added Saturday delivery at no additional cost to me. I appreciate the gesture. I was told it is "extremely likely" I would receive the meds tomorrow, though it does not look like that is guaranteed.
I meant to also say that according to my wife, I've been a complete bitch all week, whining and complaining about everything, so it's entirely possible I have overreacted a tad on this issue. I think that some of my frustration was warranted, but I, perhaps, fixated on it more than necessary. I'm not usually a complainer. Must be the high e2 
johndoesmith
Member
I meant to also say that according to my wife, I've been a complete bitch all week, whining and complaining about everything, so it's entirely possible I have overreacted a tad on this issue. I think that some of my frustration was warranted, but I, perhaps, fixated on it more than necessary. I'm not usually a complainer. Must be the high e2
Hey man, we've all been there before, I know I have. Hormones are almost insidious with how they affect your behavior without you knowing it.
The fact that you're aware of it, and apologetic about it speaks volumes about your character.
Dr Justin Saya MD
Moderator
One note for clarification here, most of the customized dosages that are ordered from the compounding pharmacies are not medications that you can simply go pick up at a pharmacy. In other words, they are custom compounded (i.e. made by the compounding pharmacy) in a specific dosage that is not stocked and carried at traditional pharmacies (example- anastrozole is only carried/stocked in 1mg tablets at traditional pharmacies). Thus, the up to 72 hour window afforded to the compounding pharmacies accounts for the time needed to actually compound and prepare the ordered medication. This holds true even for compounding pharmacies that may be local to the patient. The shipping time, on the other hand, is certainly more specific for telemedicine.
That all makes sense. Like I said above, I've been much more on edge and impatient this week than is my norm, so my apologies if I've been overly dramatic about all this.
The anastrozole arrived Saturday (thanks again Defy for setting up the Saturday delivery), so I took one pill Saturday and one again this morning. Unfortunately I came down with an absolutely brutal stomach bug Friday night/Saturday morning (the joys of two kids in daycare) that put me in a fetal position on the couch for the better part of the weekend. I'm back on my feet but still not fully recovered, so I'm going to refrain from making any subjective comments about the effects of the anastrozole. I feel pretty terrible today, but I don't think it has anything to do with clomid or anastrozole.
I took my third dose of anastrozole (0.25mg EOD), and am noticing a few things, some positive, some negative. The positive - bloating seems to be down a good bit from last week. Nipples seem back to normal, and my mood seems to have stabilized (at least back to baseline, which is a significant improvement over where it was last week).
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The negative - I'm still not noticing any real improvement of the underlying symptoms. That is to say, I feel more or less like I have for a while, meaning that I'm not still noticing any real clomid-relatd abatement of symptoms. The anastrozole also seems to make me rather nauseous. As noted above, I battled a nasty bug over the weekend, so when I felt nauseous after Monday's pill, I chalked it up to still recovering from being sick, but yesterday (no pill) I had almost no nausea, but have been very nauseous this morning after taking the anastrozole. I'm hoping that's a temporary thing. I'm also continuing to get very overheated at night, usually waking up at least once drenched in sweat. Maybe that's some of that retained water working it's way out?
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Anyway, overall, I feel about the same now as I did pre-clomid and pre-anastrozole. The anastrozole seems to be helping some of the high e2 symptoms I was battling last week, but hasn't "unmasked" any clomid-related improvements that high e2 was masking, at least yet. My next consult with Dr. Saya is on Monday, so we'll see where all this goes.
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The negative - I'm still not noticing any real improvement of the underlying symptoms. That is to say, I feel more or less like I have for a while, meaning that I'm not still noticing any real clomid-relatd abatement of symptoms. The anastrozole also seems to make me rather nauseous. As noted above, I battled a nasty bug over the weekend, so when I felt nauseous after Monday's pill, I chalked it up to still recovering from being sick, but yesterday (no pill) I had almost no nausea, but have been very nauseous this morning after taking the anastrozole. I'm hoping that's a temporary thing. I'm also continuing to get very overheated at night, usually waking up at least once drenched in sweat. Maybe that's some of that retained water working it's way out?
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Anyway, overall, I feel about the same now as I did pre-clomid and pre-anastrozole. The anastrozole seems to be helping some of the high e2 symptoms I was battling last week, but hasn't "unmasked" any clomid-related improvements that high e2 was masking, at least yet. My next consult with Dr. Saya is on Monday, so we'll see where all this goes.
CoastWatcher
Moderator
Yep. First clomid dose was February 27, so right at 2 months (this is the 8th week). Glad to hear (at least anecdotally) that the night sweats are not uncommon.
I had my second consult with Dr. Saya yesterday and wanted to update this thread. In reviewing my last round of labs, he was happy with my response to clomid so far (other than the elevated estradiol, which is being treated with anastrozole now). He believes there still is a chance I'll feel some positive effects once estradiol comes down and stabilizes. The anastrozole may also bring my elevated SHBG down some.
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Regarding my consistently high DHEA, he doesn't believe it is a cause for concern or something we need to try to treat in any way. He said I'm just a "high DHEA guy." DHT also is elevated, but is consistent with elevated testosterone numbers so no real cause for concern. All other numbers are in a good place.
What really caught his attention was cortisol. While each of the four tests were in range, I had a huge drop (like 80%) in cortisol from my 8am reading to my noon reading. Most of my symptoms seem to manifest each day late morning and carry through into the afternoon, and I tend to be at my best early in the morning. The steep drop off in cortisol could explain this.
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The plan for now is to continue clomid at 12.5mg ED, anastrozole at 0.25mg EOD, vitamin D3, stinging nettle, and then add in an adrenal adaptogen containing rhodiola, ashwagandha, and licorice root to help with the cortisol drop.
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We will retest testosterone, estradiol, and maybe a few other things in 5 weeks and reevaluate. The longer-term plan, once estradiol is stabilized at a good place, will be to titrate down and off the clomid to see if my numbers remain higher than before or whether I return to pre-clomid numbers.
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Regarding my consistently high DHEA, he doesn't believe it is a cause for concern or something we need to try to treat in any way. He said I'm just a "high DHEA guy." DHT also is elevated, but is consistent with elevated testosterone numbers so no real cause for concern. All other numbers are in a good place.
What really caught his attention was cortisol. While each of the four tests were in range, I had a huge drop (like 80%) in cortisol from my 8am reading to my noon reading. Most of my symptoms seem to manifest each day late morning and carry through into the afternoon, and I tend to be at my best early in the morning. The steep drop off in cortisol could explain this.
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The plan for now is to continue clomid at 12.5mg ED, anastrozole at 0.25mg EOD, vitamin D3, stinging nettle, and then add in an adrenal adaptogen containing rhodiola, ashwagandha, and licorice root to help with the cortisol drop.
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We will retest testosterone, estradiol, and maybe a few other things in 5 weeks and reevaluate. The longer-term plan, once estradiol is stabilized at a good place, will be to titrate down and off the clomid to see if my numbers remain higher than before or whether I return to pre-clomid numbers.
CoastWatcher
Moderator
That's an interesting question. I guess I would say a little of both. On the one hand, I'm almost two months into this journey without any noticeable improvement in underlying symptoms. I've invested a lot of time to educate myself and understand what is being examined and tested, and a not insignificant amount of money on consults, lab tests, and supplements and medication. I would have liked to experience even a small degree of improvement by now.
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On the other hand, I also recognize that in treating hormonal issues, two months is nothing. I have to remind myself daily that this is a process, to be patient (and sometimes I fail at that), and to trust in the medical care I have invested in. I'm hopeful because Dr. Saya makes me believe that there will be improvement, it just will take time and experimentation to get there.
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I also appreciate (most of the time) that we're starting with conservative approaches like supplements and seeing my response to clomid rather than diving straight into more aggressive treatments like injections of testosterone, hydrocortisone, or sermorelin. It may turn out that some of those more aggressive treatments come into play in the future, but I appreciate taking a more measured and thoughtful path initially.
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So, to answer your question, I'm not resigned, just disappointed, but still hopeful enough to keep working the process.
CoastWatcher
Moderator
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