Hello, new member here. Questions about my start so far on TRT

[WrenchHead80]

I did call on Monday. The new patient coordinator was very knowledgeable and helpful. He explained everything clearly. The only possible problem may be that I live in ny. He said he couldn't guarantee I wouldn't run into a problem with the blood work being done in ny. He said LabCorp may try billing me and billing them (Defy) even if I pay for the test threw there (Defy) website and I can end up with a huge bill somehow. He suggested driving to PA to get the blood work done, which I'm really not liking. I live on Long Island and have to drive threw the city. Not a fan of the city. I told him I want to go to a labCorp and feel it out and ask if they are okay with it.

I went to a LabCorp place today and said I will be using a clinic in Florida to prescribe meds and they need blood work done to monitor me. I said I would pay the clinic for the blood work paper work and they would give me a print out to bring to you guys to have done, Is that a problem? She asked if I had insurance, I told her yes and showed her my card. She said no problem. Now does this mean shes going to bill my insurance or just use it as insurance in case they don't get their money from Defy then they bill my insurance? I've already had two blood works done from my pcp to confirm I had low #'s, then the first bad clinic I went to ran two labs, then the current clinic just ran one lab threw labcorp, this was all threw my insurance and they paid for all the blood work. If that's the case I read that Defy can "provide a prescription for your blood work if you have a lab which is covered by your insurance" in a email I got from Defy. If that's the case I'm thinking having it done threw my insurance would be the way to go. How would I know if my insurance starts getting pissed off with all the blood work? I don't want to call them and possibly bring attention to myself where now I'm sailing fine.

Anyone here use or know someone that uses Defy that lives on long island ny?

I will be calling Defy back tomorrow with this info and see what he says. I'm hoping I can get the bloods done threw my insurance so the saved money can be used for what ever additional stuff I will need for my thyroid ect and to afford dr follow ups instead of the cheaper nurse follow ups. He also mentioned they can help with my low shbg with meds. I'm hoping everything works outs.

 

[ratbag]

Good on ya Wrench, it takes time it seems on every level just to get things workin'

 

[WrenchHead80]

Good on ya Wrench, it takes time and money it seems on every level just to get things workin'

Fixed it lol.

I started the process finally. Got the physical done and sent back to Defy earlier this week. Yesterday I was able to get my blood work done which worked out great cause I got it done in the afternoon right before my 3pm Test shot. So I should see what my actual FT and TT levels are this time. Defy was willing to work with my labs from a few weeks ago but I explained that's when I was taking 180mg a week and was told to miss my Monday morning shot for my Tuesday blood work. Felt they weren't going to have a true picture of whats going on with my current protocol and want to give them the best shot at helping me. So I decided to go with all new labs that they required. They were nice enough to email me the full list of their initial blood work labs and included their list of the full thyroid panel also. I took that list and added on Iron, TIBC, Ferritin and went to a 24 hour clinic that I confirmed with my insurance before hand they cover blood work at and explained to the dr what I was doing. He agreed to help me! Only problem is I think they were having a problem finding sensitive estrodiol. They said they will try to find it but today I went on my patient portal and noticed estrodiol. So I may end up with the estrodiol one again. Plan on calling Defy tomorrow and ordering just that test threw them and see how it works out with using the LabCorp here.

After I get my new labs Ill upload them here for anyone interested and to get a better idea of my thyroid problem.

 

[WrenchHead80]

Just picked up labs. Sent to Defy. Waiting to hear back if they have everything and I can make my consultation appointment soon.

In the mean time here are the newest labs. They were taken right before my Wednesday 3pm test shot. I did not fast though.

Am I right to say my RBC, Hemoglobin and Hematocrit have remained the same if the slightly different range from this lab is factored in? As Ive mentioned before my numbers have always been on the high side even before starting TRT. Was one thing I wanted to mention to Defy to understand why. I worry about it being close and possibly being over one day and me being refused my medication. Since right now is the best I have ever felt in my life, I don't want to loose it.

My triglycerides are high again. Did a quick search and read "Causes of high triglycerides include hypothyroidism, kidney disease, and certain inherited lipid disorders." Hoping fixing the hypothyroidism may fix this and my low SHBG???

Does the additional thyroid numbers help now to figure out my problem? I also see my Ferritin is very low.

 

[Vince Carter]

The low iron/ferritin can have some impact on Thyroid but the piece to be really concerned about is the antibodies...you need to be evaluated for something called Hashimotos before you go any further with Thyroid. I believe the antibodies should be close to zero and you're ~mid range which is cause for concern.

 

[Vettester Chris]

I didn't see Iron serum, but ferritin is way too low, T3 isn't going to transport to the cells, at least not in any optimal fashion. In my previous posts, it was noted about which labs are Needed: FT3, FT4, RT3 & Antibodies, and I also noted to ditch any of these useless uptake and index labs. Having anticipation to look at your new post and updates, I don't see any FT3 or FT4 labs, neither antibody for the enzymes or proteins, and I can't really gauge the RT3 result with a comparative ratio, and to boot those uptake and index labs are back, no bueno!

 

[WrenchHead80]

I didn't see Iron serum, but ferritin is way too low, T3 isn't going to transport to the cells, at least not in any optimal fashion. In my previous posts, it was noted about which labs are Needed: FT3, FT4, RT3 & Antibodies, and I also noted to ditch any of these useless uptake and index labs. Having anticipation to look at your new post and updates, I don't see any FT3 or FT4 labs, neither antibody for the enzymes or proteins, and I can't really gauge the RT3 result with a comparative ratio, and to boot those uptake and index labs are back, no bueno!

I was afraid you were going to say things were missing. I gave that 24 hr clinic the list you said and this was what I got back. I seem to have little luck with this.

I forwarded all my labs to Defy yesterday and they were looked over and okayed to make my consultation appointment this morning, which I made (will be in two weeks). Should I be worried they aren't going to have enough info to prescribe the proper thyroid medications for me??? I mentioned on my Defy intake form I need help in the thyroid department too. So I figured they have to know.

I was trying to get everything they may need to make a diagnosis and treatment plan for me at my consultation.



EDIT! I just went on the clinics online page where I can review my labs and notice there are more labs on there then the lady printed out for me which is what I uploaded on here and sent to Defy.

Give me some time and I will retrieve ALL the info and put it up here and forward to Defy. Thanks for saying something and getting me to look more into my labs.

Thanks for continued help

 

[WrenchHead80]

Here are the complete labs. I see some things or still missing but at least I found more information.

Will this be enough for Defy to work with? Do you guys have a better idea of what my problem is?

Hashimotos as Vince mentioned? Found additional Thyroid Peroxidase Antibodies test with a high level which would suggest that right?

From my short time reading today, early or stage 3 of Hashimoto's or maybe central hypothyroidism?

As mentioned I did not fast for these labs. Assuming that's why my lipid panel is worse?

EDIT to add: Why do I have two Estradiol labs with different #'s ? The personal info i cut off is the same between the two pages other then the received dates or different. The 30.2 number was 4/29/2018 and the 38.0 ones received date is 5/01/2018 ??

Also last lab page is from my previous blood work a couple weeks ago but have the free T3 T4 #'s

 

[Vettester Chris]

Wrench, as I had mentioned in Post 49, something "could" be triggering the unusual sub-reference hormone values, and indeed it is. Your TPO is flagged, you need to talk to Defy about autoimmune/hashis.

Anti TPO is an autoimmune disorder that targets the enzymes in the thyroid. On a semi-good note, TPO can be treated ... A little extra selenium (split AM/PM), and NDT medication titrated to a level that can mitigate the autoimmune attacks. I have seen/heard guys taking 4 to 6 grains/day to make it work, but it can work.

And ... Get yourself going on an elemental iron regiment, split dosages, plenty of Vitamin C in conjunction with this regiment. That ferritin needs to get up, min of 100. Your iron serum needs to come up another 30 points or so as well. This is the horse before the cart with/before jumping into thyroid treatment. If you don't deal with this, your T3 will just end up pooling, T4 will will convert at higher rates to RT3, then it will be more problematic. Talk with defy about all of this, protocols, dosages, etc.

Keep us posted ... Thanks

Note for any of the ladies that might be reading this thread, having similar thyroid values (below reference range T4, T3) and a TSH level with mid value or low value (or no value) ... Estrogen dominance can ultimately take a similar toll and pathway on the thyroid, via havoc and chaos on the adrenal glands and other imbalance issues related to the absence of progesterone. Antibodies should be checked, and iron/ferritin is equally essential, but keep estrogen dominance (the other ED) on the short list if the thyroid is tanking and menopause is in play. If someone relates to this topic, start a new thread and let's dive into it.

 

[WrenchHead80]

Wrench, as I had mentioned in Post 49, something "could" be triggering the unusual sub-reference hormone values, and indeed it is. Your TPO is flagged, you need to talk to Defy about autoimmune/hashis.

I have my consultation in two weeks and will mention it. I mentioned thyroid problems on my intake form for them in advance.

Anti TPO is an autoimmune disorder that targets the enzymes in the thyroid. On a semi-good note, TPO can be treated ... A little extra selenium (split AM/PM), and NDT medication titrated to a level that can mitigate the autoimmune attacks. I have seen/heard guys taking 4 to 6 grains/day to make it work, but it can work.


And ... Get yourself going on an elemental iron regiment, split dosages, plenty of Vitamin C in conjunction with this regiment. That ferritin needs to get up, min of 100. Your iron serum needs to come up another 30 points or so as well. This is the horse before the cart with/before jumping into thyroid treatment. If you don't deal with this, your T3 will just end up pooling, T4 will will convert at higher rates to RT3, then it will be more problematic. Talk with defy about all of this, protocols, dosages, etc.

Should I wait till I speak to Defy in two weeks before starting the mentioned supplements? If I understand you right, my body will need these things before any medications will be able to work right? So I would be getting a head start if that's what their going to tell me to start with. If I should start now what brand,dose and schedule do you recommend?

Did a quick search on amazon and saw these. Is the elemental iron with the C a good option? Other brands?

https://www.amazon.com/dp/B004LT0P5...olid=1VDTJR82I42PZ&psc=0&ref_=lv_ov_lig_dp_it

https://www.amazon.com/dp/B00014ECF...olid=1VDTJR82I42PZ&psc=0&ref_=lv_ov_lig_dp_it


This good selenium? Like you said once in the AM and PM
https://www.amazon.com/dp/B00SJKPBN...colid=1VDTJR82I42PZ&ref_=lv_ov_lig_dp_it&th=1

Will these supplements cause my RBC, Hemoglobin and Hematocrit #'s to go up? Don't want to get flagged if I go over.

Thanks again for taking the time educating and teaching me this stuff.

 

[Vettester Chris]

Wrench, you could probably get Dr. Saya to give you a little feedback on the supplements prior to your consultation. Maybe send a message or call. He will post on the forum from time to time as well, it just depends on his schedule.

If it were me, hypothetically speaking, I would start taking all three (3) of those, 1 in the AM with 1,000mg vitamin C, and 1 of each late afternoon/pm with 1,000mg of vitamin C at each setting (noted selenium at 200mg x 2 for 400mg total). That's just me, run it by the team at Defy. If anything they might have you adjust the dosages (?)

Like anything, you will need to keep an eye on the CBC's, re: HCT and RBC. Labs will tell you where things are at, advise your medical team if your intent is to donate blood. That can also contribute to lowering iron & ferritin, so it can become a delicate balance with the supplements and everything else.

 

[WrenchHead80]

Wrench, you could probably get Dr. Saya to give you a little feedback on the supplements prior to your consultation. Maybe send a message or call. He will post on the forum from time to time as well, it just depends on his schedule.

If it were me, hypothetically speaking, I would start taking all three (3) of those, 1 in the AM with 1,000mg vitamin C, and 1 of each late afternoon/pm with 1,000mg of vitamin C at each setting (noted selenium at 200mg x 2 for 400mg total). That's just me, run it by the team at Defy. If anything they might have you adjust the dosages (?)

Like anything, you will need to keep an eye on the CBC's, re: HCT and RBC. Labs will tell you where things are at, advise your medical team if your intent is to donate blood. That can also contribute to lowering iron & ferritin, so it can become a delicate balance with the supplements and everything else.

Thanks again for all the help!

 

[Vince Carter]

For Ferritin what worked for me was Ferrets 325 with 2g of Vitamin C and 1g of Lysine. This was the only way I got my Ferritin to budge upward.

https://www.amazon.com/Pharmics-Fer...33196&sr=8-3&keywords=ferrets+iron+supplement

I started using this on reading some Amazon reviewers stating that this worked for them. Lower doses of other Iron supps were pretty inneffective for me. The L-Lysine helps aid absorption as does the Vit C

 

[Vettester Chris]

Excellent information from VC!!

 

[WrenchHead80]

For Ferritin what worked for me was Ferrets 325 with 2g of Vitamin C and 1g of Lysine. This was the only way I got my Ferritin to budge upward.

https://www.amazon.com/Pharmics-Fer...33196&sr=8-3&keywords=ferrets+iron+supplement

I started using this on reading some Amazon reviewers stating that this worked for them. Lower doses of other Iron supps were pretty inneffective for me. The L-Lysine helps aid absorption as does the Vit C

Thanks Vince C. Do you take it once a day? Did raising your ferritin raise your RBC, Hemoglobin and Hematocrit #'s?

I'm been reading more on all this stuff and Ive heard a couple times you treat the low iron and the ferritin will follow. Is that true? Can Ferritin be targeted by itself or will iron increase with it or first?? I bought the three supplements from post 70 btw and started a couple a days ago, taking all once a day.

 

[ratbag]

FYI, my MD claims low ferritin must be treated aside of what iron serum is. He also claims if you have trouble supping iron that you should try liquid iron (never tried it) he claims your body absorbs it much easier. I have to try it one of these days!

 

[WrenchHead80]

Forgot to update:

Had my Defy consolation last week. Really glad I switched to them. Very friendly and well informed people. As far as my trt protocol, he said I can leave it how it is.

I was tempted to ask about going to everyday shots since I'm low shbg but felt knowing I was going to start a thryroid treatment plan I shouldn't change more then one thing at a time. Also read the T3 in the ndt may raise my shbg? So maybe after getting dialed in on the thyroid med I may come to find I'm no longer a low shbg guy anymore?

As far as the thyroid goes, he wanted me to start at 30mg(half grain) of Armour. I mentioned hearing people on hear complaining about quality control lately and pricing. So I got desiccated thyroid capsules instead and saved a lot of money. Where going to run labs again in 4 weeks. I mentioned I wanted to be on the safe side and take it slow since I used to suffer from anxiety and heard too much or too fast can cause "hyper" issues. Also concerned if my iron levels bounced back in enough time. I'm thinking that's why i'm starting at half and not full grain. Mentioned reading a lot from you guys and STTM and mentioned hearing the dose may have to be raised more after 2 weeks if symptoms appear worse. He seemed fine with that if needed.

I've read you do your starting dose for two weeks then raise by half grain every two weeks as needed but stop at 2 grains and get blood test done at that level before raising more. So I'll see how I feel these next coming days and if I think a raise is needed I will run it by Defy with a call first.

I will mention the first day I started I became really tired. Today is my second day and still feel tired but no where near as bad as yesterday.

He was also fine with me taking the three supplements I mentioned above. Taking only one selenium pill a day (200mcg). Which in all my reading seems to be the normal dose given.

Will also mention a interesting find I made after my consultation and waiting for my meds to come. I read about how your temperature can be used as a gauge if you suffer from hypo or hyper thyroid problem and it can help determine if more or less NDT is needed. Thought that was cool and decided to start taking my temp in the morning and afternoon. To my surprise and guess relief cause at least it confirms my problem, my morning temp was high 96 or low 97 waking up brrrrrrrr. Late afternoon it would go up to around 97.5 to 98.20 . This is all pre thyroid meds. This morning I was already warmer waking up at 97.5 . I will definitely inform Defy of this info.

I am worried I may have a adrenal problem based on test 4 here... https://stopthethyroidmadness.com/adrenal-info/

I do pass Test 1 2 and 3.

Now I understand why Chris said get a 24 hr saliva test done. Should I worry the NDT won't work or as good as it should?

 

[Deleted member 16042]

Just to share a little of my experience with NDT: Same deal. I started with Defy on 1/2 grain then raised to 1 grain. When I started and when I raised to 1 grain I felt a little like I was over caffienated for a couple days then it evened out. I seem to be doing well now on NDT though I get a little tired in the late afternoons/early evenings sometimes. Definitely feel more energetic in the mornings, and I run warmer. I used to have cold hands and feet all the time, none of that now. My latest blood tests showed T3 over range a couple hours after taking the NDT, but probably levels drop to normal range in the afternoons.Might need future adjustment or possibly T4 added since I have high T3 but low T4, but the good news is I am converting the T4 to T3 just fine.

Everybody's different. I guess I just want ed to say that you might feel a little amped for a couple days when increasing dosage. If it doesn't even out, decrease dose and contact Defy.

 

[WrenchHead80]

Thank you Blackhawk for sharing. I'm kind of glad now i started on 1/2 grain after hearing from your experience. Last thing I want is to feel amped up on coffee. Finally getting use to having no anxiety anymore these last month's, so the last thing I want is that back.

I will say it's midnight as I'm writing this and don't feel tired like i normally would. But i also dont feel amped up which is good. Last night I was able to lay down and fall asleep for the night, hopefully I can again tonight.

 

[1Draw]

Forgot to update:

Had my Defy consolation last week. Really glad I switched to them. Very friendly and well informed people. As far as my trt protocol, he said I can leave it how it is.

I was tempted to ask about going to everyday shots since I'm low shbg but felt knowing I was going to start a thryroid treatment plan I shouldn't change more then one thing at a time. Also read the T3 in the ndt may raise my shbg? So maybe after getting dialed in on the thyroid med I may come to find I'm no longer a low shbg guy anymore?

T3 Cytomel raised my SHBG a LOT! Started Cytomel 2/28 due to high RT3 (28.1). Just completed my labs for Defy consult SHBG went from 76.4 on 12/26/17 to 124.5 on last blood draw 5/21/18. So yes it can raise SHBG in some, and certainly did for me. My RT3 was 13.1 on 5/21 after 2 1/2 months on 20-30 mcg day of Cytomel. Have stopped the Cytomel since it accomplished its purpose but, it drained my FT4 - 0.76 (0.82 - 1.77) so, guess Defy will put me on a T4 med or will it rise on its on? A question for our thyroid guru's ratbag and Chris V.