Defy recommended Dr, PA or NP from your experience

[MaxP]

Hello, I am a 60 year old male and in the process of scheduling my consultation for TRT with Defy and was given a choice from different Dr's, PA's or NP's to choose from. I want to get the best consultation and treatment plan so figured I would ask in this forum for reccomendations of who to see or not from their experiance.
I was on Cypionate 50mg weekly earlier this year through my pcp but stopped around 3 month or more ago due to not feeling any different and my pcp's knowledge with TRT. I stopped as I figured I would start fresh with Defy after a few months.
My testosterone level was 320 with am test and 197 with late afternoon test before starting TRT and 635 when on Cypionate 50mg weekly.
I now have recent test results for the full lab work that Defy requires and am surprised that my testosterone level is at 436 at the moment considering I have not been on Cypionate.

1. I look forward to getting recommendations for Defy's Dr's, PA's or NP's to choose from
2. I can post specific lab results for any insight, just let me know which ones.

 

[mooseman109]

I have been with dr. Calkin for a few years and quite happy. He listens to me and treats me not just the lab numbers. We have developed a trust between us.
That being said, he is the only one there I have seen, so I do not have reference to compare with others. For me, when I het a Dr I trust and it is reciprocated, that is my guy!

 

[Phil Goodman]

I’m in the same boat as Mooseman. I started my journey there with Dr. Calkins(3+ years ago) and have been happy with all my consultations and treatment plans/options. And if I have questions about anything I’m considering he listens then gives his input without just trying to push prescriptions. For example I was considering adding CJC a few years ago(back when they could still use Empower to get it) but he let me know that with my GH levels already near the top of the range I would probably get little to nothing out of it. He’ll even give good insight into test results not related to hormones, and my consultations with him are much better than with my PCP. So yeah, I can confirm that he has been a great choice for me. Can’t compare him to any of the other staff though because I’ve just stayed with him the whole time.

 

[WhiteMale]

I only see Nurse Jill Dillenburg and that's about 10 years in total. She get's my total endorsement and recommendation.

 

[madman]

Hello, I am a 60 year old male and in the process of scheduling my consultation for TRT with Defy and was given a choice from different Dr's, PA's or NP's to choose from. I want to get the best consultation and treatment plan so figured I would ask in this forum for reccomendations of who to see or not from their experiance.
I was on Cypionate 50mg weekly earlier this year through my pcp but stopped around 3 month or more ago due to not feeling any different and my pcp's knowledge with TRT. I stopped as I figured I would start fresh with Defy after a few months.
My testosterone level was 320 with am test and 197 with late afternoon test before starting TRT and 635 when on Cypionate 50mg weekly.
I now have recent test results for the full lab work that Defy requires and am surprised that my testosterone level is at 436 at the moment considering I have not been on Cypionate.

1. I look forward to getting recommendations for Defy's Dr's, PA's or NP's to choose from
2. I can post specific lab results for any insight, just let me know which ones.

My testosterone level was 320 with am test and 197 with late afternoon test before starting TRT and 635 when on Cypionate 50mg weekly.
I now have recent test results for the full lab work that Defy requires and am surprised that my testosterone level is at 436 at the moment considering I have not been on Cypionate.


Would not get too caught up on the TT here as even though it is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

TT does not paint the full picture!

Post your FT, estradiol, SHBG, RBCs, hemoglobin and hematocrit.

Chances are you never even had your FT tested using an accurate assay.

As I stated in another posters thread:

Although you will find many on the forum who use Defy that have positive experiences you still need to tread lightly as the downfall here is from what I have seen on the forum over the years is that some of the doctors tend to overmedicate (150-200 mg T/week) from the get-go let alone they are still clueless when it comes to testing one of the most important blood markers free testosterone as they are still using/relying upon a known to be inaccurate assay the direct immunoassay!

Top it off that direct IA has been shown to underestimate FT.

Again it is critical to have your FT tested using the most accurate assay which would be the gold standard Equilibrium Dialysis especially in cases of altered SHBG!

If anything I would pay out of pocket and test your trough FT through Quest or Labcorp!

The most sensible/cost effective option would be through Nelson's discounted labs or you can use Labcorp but it is more costly!

Testosterone, Free (Equilibrium Dialysis) and Total, MS - Most Affordable and Accurate Test

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

Labcorp test details for Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

www.labcorp.com

Just Started TrT and am Very Confused

Hi, new guy here. After years of trying to combat declining T with diet, fat loss, weightlifting, etc. I finally decided to give TrT a try. At 73 years of age my T had been slowly declining to where I recently got the following report: T=328, SHBG=54.7, Free T = 4.63, Albumin 4.4. In...

www.excelmale.com

 

[MaxP]

Poo

My testosterone level was 320 with am test and 197 with late afternoon test before starting TRT and 635 when on Cypionate 50mg weekly.
I now have recent test results for the full lab work that Defy requires and am surprised that my testosterone level is at 436 at the moment considering I have not been on Cypionate.


Would not get too caught up on the TT here as even though it is important to know FT is what truly matters as it is the active unbound fraction of T responsible for the positive effects.

TT does not paint the full picture!

Post your FT, estradiol, SHBG, RBCs, hemoglobin and hematocrit.

Chances are you never even had your FT tested using an accurate assay.

As I stated in another posters thread:

Although you will find many on the forum who use Defy that have positive experiences you still need to tread lightly as the downfall here is from what I have seen on the forum over the years is that some of the doctors tend to overmedicate (150-200 mg T/week) from the get-go let alone they are still clueless when it comes to testing one of the most important blood markers free testosterone as they are still using/relying upon a known to be inaccurate assay the direct immunoassay!

Top it off that direct IA has been shown to underestimate FT.

Again it is critical to have your FT tested using the most accurate assay which would be the gold standard Equilibrium Dialysis especially in cases of altered SHBG!

If anything I would pay out of pocket and test your trough FT through Quest or Labcorp!

The most sensible/cost effective option would be through Nelson's discounted labs or you can use Labcorp but it is more costly!

Testosterone, Free (Equilibrium Dialysis) and Total, MS - Most Affordable and Accurate Test

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

500726: Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences) | Labcorp

Labcorp test details for Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)

www.labcorp.com

Just Started TrT and am Very Confused

Hi, new guy here. After years of trying to combat declining T with diet, fat loss, weightlifting, etc. I finally decided to give TrT a try. At 73 years of age my T had been slowly declining to where I recently got the following report: T=328, SHBG=54.7, Free T = 4.63, Albumin 4.4. In...

www.excelmale.com

Thank you for your response, I will check out the links.
The lab work that's requested by Defy was done through LabCorp:

TT = 436
FT (Direct) = 7.9
Estradiol = 28.3
Estradiol Sensitive = 23.5
SHBG = 37.5
RBC = 5.58
Hemoglobin = 16.1
Hematocrit = 48

 

[madman]

Poo


Thank you for your response, I will check out the links.
The lab work that's requested by Defy was done through LabCorp:

TT = 436
FT (Direct) = 7.9
Estradiol = 28.3
Estradiol Sensitive = 23.5
SHBG = 37.5
RBC = 5.58
Hemoglobin = 16.1
Hematocrit = 48

Yes the wrong FT assay was used!

Your FT is most likely even lower.

Regardless with a not so stellar TT 436 ng/dL and normalish SHBG 37.5 nmol/L your FT would be on the bottom-end.

Just make sure when you start therapy and go for your next set of labs once blood levels have stabilized (4-6 weeks TC/TE) that you have your FT tested using an accurate assay which again would be the gold standard Equilibrium Dialysis.

Also need to keep an eye on your RBCS, hemoglobin and hematocrit as you are already close to the top-end pre-TTh and it is a given that you will end up driving it over the top-end especially if you are running a high trough/steady-state FT!

RBCs, hemoglobin and hematocrit are critical blood markers which need to be monitored when using exogenous T.

Hematocrit will increase within the 1st month of starting therapy and can take anywhere from 6-9 months and in some cases up to a year to reach peak levels!

 

[MaxP]

Yes the wrong FT assay was used!

Your FT is most likely even lower.

Regardless with a not so stellar TT 436 ng/dL and normalish SHBG 37.5 nmol/L your FT would be on the bottom-end.

Just make sure when you start therapy and go for your next set of labs once blood levels have stabilized (4-6 weeks TC/TE) that you have your FT tested using an accurate assay which again would be the gold standard Equilibrium Dialysis.

Also need to keep an eye on your RBCS, hemoglobin and hematocrit as you are already close to the top-end pre-TTh and it is a given that you will end up driving it over the top-end especially if you are running a high trough/steady-state FT!

RBCs, hemoglobin and hematocrit are critical blood markers which need to be monitored when using exogenous T.

Hematocrit will increase within the 1st month of starting therapy and can take anywhere from 6-9 months and in some cases up to a year to reach peak levels!

Thank you for your response.
Since my consultation with Dr Calkin @ Defy isn't until later this month, I have time to get the correct FT test done, hopefully through my PCP.
Would this be the correct one:

LabCorp:
Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)
TEST: 500726

Anything else that would be helpful to collect before my consultation?

 

[Phil Goodman]

Thank you for your response.
Since my consultation with Dr Calkin @ Defy isn't until later this month, I have time to get the correct FT test done, hopefully through my PCP.
Would this be the correct one:

LabCorp:
Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)
TEST: 500726

Anything else that would be helpful to collect before my consultation?

Probably goes without saying, but I always have a small checklist of questions or topics I want to discuss so I make sure I don’t miss anything.


Also, another thing I mention to people is that if you start out lower than the recommended dose you can start working on a reserve supply of your medication. I’m not in the business of telling people how to manage their health or when they should or shouldn’t strictly follow a doctor’s suggestions…. But everyone should have extra medication on hand for emergencies, and with how strict prescribers are with test, that seems to be about the easiest(legal) way to build a reserve.

 

[madman]

Thank you for your response.
Since my consultation with Dr Calkin @ Defy isn't until later this month, I have time to get the correct FT test done, hopefully through my PCP.
Would this be the correct one:

LabCorp:
Testosterone, Free, Mass Spectrometry/Equilibrium Dialysis (Endocrine Sciences)
TEST: 500726

Anything else that would be helpful to collect before my consultation?

Yes you can either test your FT using Labcorp's or better yet through Nelsons Discounted labs which uses Quest Diagnostics.

This would be the more cost effective option:

Testosterone, Free (Equilibrium Dialysis) and Total, MS - Most Affordable and Accurate Test

Get an affordable and accurate testosterone test results with our Total Testosterone, M and Free (Equilibrium Dialysis) test. Visit DiscountedLabs.com for more information.

www.discountedlabs.com

No point in retesting your FT now as your baseline is going to most likely be at the bottom-end with a not so stellar TT 436 ng/dL and normalish SHBG 37.5 ng/dL.

Just make sure going forward that when you start therapy and blood work is done again at the 4-6 week mark once blood levels have stabilized to see where said protocol (dose of T/injection frequency) has your trough TT, FT, estradiol let alone other critical blood markers RBCs, hemoglobin and hematocrit that you have your FT tested using the most accurate assay.

Again where your hematocrit sits 4-6 weeks in is not where it will end up in the long run as again levels will increase within the 1st month of starting therapy and can take anywhere from 6-9 months or in some cases up to a year to reach peak levels.

Your RBCs,hemoglobin and hematocrit are already hovering close to the top-end so do not be alarmed if you are pushing a hematocrit >50% 4-6 weeks in let alone 6-9 months down the road as it is a given driving up your FT will raise your hematocrit when using injectable esterified T.

If you are one who ends up running too high a trough/steady-state FT you will most likely be struggling with elevated hematocrit!