Getting first blood test since starting TRT...Do I need to add anything to the test?

[Belmundo]

Getting ng in touch with Defy is as easy as picking up the phone. Call them and begin to out your mind at ease. Dr. Saya did NOT wrote that YOU needed tamoxifen- he isn't your doctor and hasn't examined you. He wrote that it was reasonable therapy for men with diagnosd gynocomastia who had failed to reverse it with Anastrozole. That was a general statement, not specific to your case. The doctor managing your case has seen you make several changes to your protocol, develop high anxiety, and begin discussing further changes. He undoubtedly wonders if TRT is something that makes sense for you.

Imwould call Defy. I would find a surgeon and have him/her examine you. I would make no changes to your protocol. I would test if it puts your mind at ease.

Several changes? The only thing I did was take anastrozole to try and reverse the lumps based on a protocol I found on several TRT forums that stated .5mg EOD. Should I have re-consulted with the PrimeBody guy, yeah probably but when I originally told him I felt sensitivity and similar feelings to when I experienced a lump when I took Anavar, all he said was to wait for bloods, that nothing bad will happen and then when the lumps became more pronounced all he said was if you're concerned take .5mg. And that was it. No detailed info or explanation on a dosage scheduling. This is poor medical care in my opinion. How else am I supposed to react? I'm questioning things because my 30 E2 may look good but obviously my body is reacting poorly to that level and there was no other statements made about my blood work from him or other countermeasures to take in regards to the lumps except for "stop treatment".

 

[Belmundo]

And I said that Dr. Saya said I might need tamoxifen. I never said that he said I should take it so I don't know where you're getting that from. I'm just pointing out that my doctor said to just stop and hasn't mentioned anything else about it.

 

[CoastWatcher]

Several changes? The only thing I did was take anastrozole to try and reverse the lumps based on a protocol I found on several TRT forums that stated .5mg EOD. Should I have re-consulted with the PrimeBody guy, yeah probably but when I originally told him I felt sensitivity and similar feelings to when I experienced a lump when I took Anavar, all he said was to wait for bloods, that nothing bad will happen and then when the lumps became more pronounced all he said was if you're concerned take .5mg. And that was it. No detailed info or explanation on a dosage scheduling. This is poor medical care in my opinion. How else am I supposed to react? I'm questioning things because my 30 E2 may look good but obviously my body is reacting poorly to that level and there was no other statements made about my blood work from him or other countermeasures to take in regards to the lumps except for "stop treatment".

Of course it's poor medical care. You certainly deserve better, as has been suggested in posts earlier in this thread. I was suggesting how your doctor probably was reacting - not how he should have reacted. I do feel that contacting Defy, having your breast area evaluated, and following the protocol is in your best interests. You can certainly push your Anastrozole level lower, but if you up your dose testing is particularly important.

 

[Belmundo]

Of course it's poor medical care. You certainly deserve better, as has been suggested in posts earlier in this thread. I was suggesting how your doctor probably was reacting - not how he should have reacted. I do feel that contacting Defy, having your breast area evaluated, and following the protocol is in your best interests. You can certainly push your Anastrozole level lower, but if you up your dose testing is particularly important.

Sorry, it's sometimes hard to gauge meaning through text. I spoke to my prime body rep and I asked for a sensitive blood test only because I think it will help in determining a protocol moving forward. Hopefully I can get that taken care of tomorrow in the AM and I'll be contacting Defy sometime today, if not, first thing in the morning. I'll also be looking up doctors in my area who have experience with gynecomastia and surgery. Appreciate your feedback and help. Will update.

 

[CoastWatcher]

Sorry, it's sometimes hard to gauge meaning through text. I spoke to my prime body rep and I asked for a sensitive blood test only because I think it will help in determining a protocol moving forward. Hopefully I can get that taken care of tomorrow in the AM and I'll be contacting Defy sometime today, if not, first thing in the morning. I'll also be looking up doctors in my area who have experience with gynecomastia and surgery. Appreciate your feedback and help. Will update.

No worries. Keep us updated.

 

[Belmundo]

No worries. Keep us updated.

Current update:

I went to see a surgeon and their practice specializes in gynecomastia surgery. I definitely have lumps on both sides with the right side more pronounced/larger than the left. She said it's too early to consider surgery and to check back in 6-12 months.

On 1/18 I took another sensitive estradiol test but have no received the results yet. It seems to take about 5 days so I'm hoping to have the results tomorrow. However, in those 5 days, I took another 1mg of anastrozole, 50mg of Test Cyp and 700iu HCG between that time so who knows what my levels will be now.

I spoke to my Prime Body doctor again and he basically has no experience with this as none of his patients have had this kind of reaction. His recommendation was to speak to an endocrinologist and to stop treatment.

I spoke to Defy and once they get all the my required documents, it's going to be a 3-4 week waiting period before I can have my consultation. Not sure I want to risk going through the whole process and pay to only have them say stop treatment or something. Plus 3-4 weeks is insanely long.

I want to continue TRT because I do (did) feel much better on it but I feel like it's going to be difficult to get my levels dialed in. If I do make the switch to Defy, what the hell do I do for 3-4 weeks? Is it smart to just stop TRT cold turkey? Does anyone know of any endo's or doctors I can speak to in the NJ/NY area?

4 years ago I messed around with Anavar (underground lab crap) and I started to feel a lump form towards the tail end of my cycle and so I self medicated with Letrozole (underground lab crap) and it did reverse the lumps so I know this stuff will work if I'm prescribed a pharma grade version with a doctor prescribed protocol. I just don't know who to speak to or where to go from here. I asked Prime Body if they have anyone in their network that I can speak to so I'm waiting on a reply.

If anyone can ping Dr. Saya or knows of someone I can speak to, it would be greatly appreciated. Or if you have any experience or advice, that too is appreciated. Thank you.

 

[CoastWatcher]

Current update:

I went to see a surgeon and their practice specializes in gynecomastia surgery. I definitely have lumps on both sides with the right side more pronounced/larger than the left. She said it's too early to consider surgery and to check back in 6-12 months.

On 1/18 I took another sensitive estradiol test but have no received the results yet. It seems to take about 5 days so I'm hoping to have the results tomorrow. However, in those 5 days, I took another 1mg of anastrozole, 50mg of Test Cyp and 700iu HCG between that time so who knows what my levels will be now.

I spoke to my Prime Body doctor again and he basically has no experience with this as none of his patients have had this kind of reaction. His recommendation was to speak to an endocrinologist and to stop treatment.

I spoke to Defy and once they get all the my required documents, it's going to be a 3-4 week waiting period before I can have my consultation. Not sure I want to risk going through the whole process and pay to only have them say stop treatment or something. Plus 3-4 weeks is insanely long.

I want to continue TRT because I do (did) feel much better on it but I feel like it's going to be difficult to get my levels dialed in. If I do make the switch to Defy, what the hell do I do for 3-4 weeks? Is it smart to just stop TRT cold turkey? Does anyone know of any endo's or doctors I can speak to in the NJ/NY area?

4 years ago I messed around with Anavar (underground lab crap) and I started to feel a lump form towards the tail end of my cycle and so I self medicated with Letrozole (underground lab crap) and it did reverse the lumps so I know this stuff will work if I'm prescribed a pharma grade version with a doctor prescribed protocol. I just don't know who to speak to or where to go from here. I asked Prime Body if they have anyone in their network that I can speak to so I'm waiting on a reply.

If anyone can ping Dr. Saya or knows of someone I can speak to, it would be greatly appreciated. Or if you have any experience or advice, that too is appreciated. Thank you.

I'm.sorry you are facing this. Some questions. Prime Body just washed their hands of you? Was there any discussion of how to transition off TRT? Did the surgeon you consulted mention supporting you through this? Would that practice prescribe the necessary medications to support you through this?

Dr. Ronald Tamler is an endocrinologist in NY with an interest in gynecomastia. I have read presentations he has published.

http://www.mountsinai.org/profiles/ronald-tamler

 

[Belmundo]

I'm.sorry you are facing this. Some questions. Prime Body just washed their hands of you? Was there any discussion of how to transition off TRT? Did the surgeon you consulted mention supporting you through this? Would that practice prescribe the necessary medications to support you through this?

Dr. Ronald Tamler is an endocrinologist in NY with an interest in gynecomastia. I have read presentations he has published.

http://www.mountsinai.org/profiles/ronald-tamler

I spoke to the doctor tonight and he said he recommends to stop TRT and to speak with an endo familiar with TRT and gyno. He mentioned Dr. John Crisler would be someone to possibly reach out to. He didn't give any other medical advice as far transitioning/weening off TRT. He just said to stop. After that call I immediately emailed my Prime rep asking her if there was anyone in their network with more experience that I could speak to. I'm hoping there is and I'll push harder on them to help me so there may still be hope through them while I wait to move to Defy. I also emailed the Defy rep I spoke to today asking if there was any way to expedite me due to my circumstances. Not expecting much but maybe I'll be able to speak to an actual doctor who knows what they're doing.

That's a good question and my main priority going there was to try and confirm what the lumps were first. Once I had that information, I thought I would inform the prime body doctor and he would create a game plan on how to get me back on track. Whether that's exploring the possibility of a SERM, lowering all my TRT dosages as I may be sensitive to high T and how it's converting in my system, is the HCG too high and that's causing issues, or maybe increase the AI, or something. Anything except for just stop. In regards to the surgeon, I kind of got the impression that they weren't the right place to deal with the hormonal aspect of things so I may have to find a place that's familiar with both. It sounds like Dr. Tamler might fit that description. I'll give them a call tomorrow and see if I can schedule an appointment. Thank you so much Coast.

 

[CoastWatcher]

I spoke to the doctor tonight and he said he recommends to stop TRT and to speak with an endo familiar with TRT and gyno. He mentioned Dr. John Crisler would be someone to possibly reach out to. He didn't give any other medical advice as far transitioning/weening off TRT. He just said to stop. After that call I immediately emailed my Prime rep asking her if there was anyone in their network with more experience that I could speak to. I'm hoping there is and I'll push harder on them to help me so there may still be hope through them while I wait to move to Defy. I also emailed the Defy rep I spoke to today asking if there was any way to expedite me due to my circumstances. Not expecting much but maybe I'll be able to speak to an actual doctor who knows what they're doing.

That's a good question and my main priority going there was to try and confirm what the lumps were first. Once I had that information, I thought I would inform the prime body doctor and he would create a game plan on how to get me back on track. Whether that's exploring the possibility of a SERM, lowering all my TRT dosages as I may be sensitive to high T and how it's converting in my system, is the HCG too high and that's causing issues, or maybe increase the AI, or something. Anything except for just stop. In regards to the surgeon, I kind of got the impression that they weren't the right place to deal with the hormonal aspect of things so I may have to find a place that's familiar with both. It sounds like Dr. Tamler might fit that description. I'll give them a call tomorrow and see if I can schedule an appointment. Thank you so much Coast.

You have been ill-served by Prime Body. A complication arises, and you are simply told to find other care? Oh, and, by the way, simply walk away from your protocol...cold. Please - advise as to how this plays out. Doctor Crisler is certainly one of the most highly regarded doctors in this field. I hope he, Defy, and/or Dr. Tamper can intervene. Let us know.

 

[Belmundo]

You have been ill-served by Prime Body. A complication arises, and you are simply told to find other care? Oh, and, by the way, simply walk away from your protocol...cold. Please - advise as to how this plays out. Doctor Crisler is certainly one of the most highly regarded doctors in this field. I hope he, Defy, and/or Dr. Tamper can intervene. Let us know.

Another update:

So I got my sensitive estradiol blood test back on the 6th day and it was 8.1 out of (8.0 - 35.0) so the anastrozole definitely brought it down but it had little impact on the lumps and since I took more while also continuing my TRT protocol, I have no idea what my level's are at now.

I spoke with Defy and got all my paperwork submitted and I have my consultation scheduled with Dr. Saya on 2/27 which was the soonest he could speak with me.

I called Dr. Tamler and it would cost $340 for a consultation with him and the soonest he could see me would be March/April so that won't be happening.

I haven't reached out to Dr. Crisler but I'm expecting the same result as Dr. Tamler.

Since it was approaching the end of the month I got an email from Prime Body stating they shipped my meds out with the only change being Anastrozole .25mg 2x a week as opposed to 1x a week. As I mentioned, I asked Prime Body if they had someone in their network with more experience to help with my situation so I asked them again because I hadn't gotten an answer. They reached out to their medical director and this was his response "ok this is what he recommended . we are going to up your dose of Anastrozole to 0.5mg 2x a week. your estridiol was on the high side we will try that and see if that makes you feel better and retest your estradiol in 5-6 wks".

So they didn't even look at my most recent results because my new estradiol level is 8.1 not 30 anymore so clearly they have no idea what they're doing and are of no help whatsoever. I didn't even respond because I'm just lost for words by this. The lumps are not getting better and in fact feel a lot worse at certain times. I'm not going to be able to speak to Dr. Saya until another 4 weeks so I don't know what to do. Is it still possible to shrink these lumps a bit with this much time having passed? This whole situation really sucks and the fact that Prime Body isn't helping just blows my mind. In the mean time, I've lowered my HCG to about 250-270iu instead of the 350iu, to help minimize some of the amortization but who knows if it will help.

 

[CoastWatcher]

Another update:

So I got my sensitive estradiol blood test back on the 6th day and it was 8.1 out of (8.0 - 35.0) so the anastrozole definitely brought it down but it had little impact on the lumps and since I took more while also continuing my TRT protocol, I have no idea what my level's are at now.

I spoke with Defy and got all my paperwork submitted and I have my consultation scheduled with Dr. Saya on 2/27 which was the soonest he could speak with me.

I called Dr. Tamler and it would cost $340 for a consultation with him and the soonest he could see me would be March/April so that won't be happening.

I haven't reached out to Dr. Crisler but I'm expecting the same result as Dr. Tamler.

Since it was approaching the end of the month I got an email from Prime Body stating they shipped my meds out with the only change being Anastrozole .25mg 2x a week as opposed to 1x a week. As I mentioned, I asked Prime Body if they had someone in their network with more experience to help with my situation so I asked them again because I hadn't gotten an answer. They reached out to their medical director and this was his response "ok this is what he recommended . we are going to up your dose of Anastrozole to 0.5mg 2x a week. your estridiol was on the high side we will try that and see if that makes you feel better and retest your estradiol in 5-6 wks".

So they didn't even look at my most recent results because my new estradiol level is 8.1 not 30 anymore so clearly they have no idea what they're doing and are of no help whatsoever. I didn't even respond because I'm just lost for words by this. The lumps are not getting better and in fact feel a lot worse at certain times. I'm not going to be able to speak to Dr. Saya until another 4 weeks so I don't know what to do. Is it still possible to shrink these lumps a bit with this much time having passed? This whole situation really sucks and the fact that Prime Body isn't helping just blows my mind. In the mean time, I've lowered my HCG to about 250-270iu instead of the 350iu, to help minimize some of the amortization but who knows if it will help.

Prime Body has utterly failed you. You deserved better. I acknowledge they aren't surgeons, but they don't seem willing to discuss a very troubling situation with you. You deserve better. The surgeon told you it was a "watch and wait" situation from their perspective, right?

 

[Belmundo]

Prime Body has utterly failed you. You deserved better. I acknowledge they aren't surgeons, but they don't seem willing to discuss a very troubling situation with you. You deserve better. The surgeon told you it was a "watch and wait" situation from their perspective, right?

Yeah, the surgeon said to wait until my hormone levels were balanced and check back in 6-12 months but she seemed to think SERMs could help when I mentioned them. As I stated above, I don't think they were the right people to talk in regards to my situation whereas someone like Dr. Tamler would have been perfect. They were more knowledgeable in terms of surgery and removal vs. the hormone aspect of gyno.

My main concern is the amount of time that has passed from when the lumps started to form. It's weird. Throughout the day and during workouts I notice the size of the lumps fluctuate. In the morning they're really bad and after my injections they seem to minimize slightly and then kind of go back to their previous size. It makes me feel like it's still possible to reverse the lumps with something stronger but I have no idea if too much time as passed. I've been taking .25mg of anastrozole every week/10 days as I feel like my E2 was still low and I don't want to keep pounding it by taking more. I'm also probably past the point of it doing anything to the lumps. I'll be taking another full blood test Saturday the 18th so I'll have recent results for my consultation on the 27th. I'll post those when I take them. Hopefully Dr. Saya and Defy can help.

 

[CoastWatcher]

Yeah, the surgeon said to wait until my hormone levels were balanced and check back in 6-12 months but she seemed to think SERMs could help when I mentioned them. As I stated above, I don't think they were the right people to talk in regards to my situation whereas someone like Dr. Tamler would have been perfect. They were more knowledgeable in terms of surgery and removal vs. the hormone aspect of gyno.

My main concern is the amount of time that has passed from when the lumps started to form. It's weird. Throughout the day and during workouts I notice the size of the lumps fluctuate. In the morning they're really bad and after my injections they seem to minimize slightly and then kind of go back to their previous size. It makes me feel like it's still possible to reverse the lumps with something stronger but I have no idea if too much time as passed. I've been taking .25mg of anastrozole every week/10 days as I feel like my E2 was still low and I don't want to keep pounding it by taking more. I'm also probably past the point of it doing anything to the lumps. I'll be taking another full blood test Saturday the 18th so I'll have recent results for my consultation on the 27th. I'll post those when I take them. Hopefully Dr. Saya and Defy can help.

I can imagine how frustrated you must be at this point. Good money spent on, what you believed, was good care, only to have that medical practice essentially disappear when unanticipated side effects presented.

 

[Mastan]

Dear Dr.Belmundo.

I am currently working with a publisher and my author is interested in using one of the tables from your article in our upcoming book. Can you please confirm if you are giving us permission to use it? Additionally, we require a high-quality table. Would you be able to provide that?

Have a great day!

Regards,
Basha

 

[Mastan]

Dr. Belmundo,

I am currently working with a publisher and my author is interested in using one of the tables from your article in our upcoming book. Can you please confirm if you are giving us permission to use it? Additionally, we require a high-quality table. Would you be able to provide that?

Have a great day!

Regards,
Basha