My Defy Medical consultation experience and plan of action.

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Systemlord

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I finally had my Defy Medical consultant today and it went better than I had expected, Dr. Saya is in a league of his own for sure. Dr. Saya hit on important points that were never covered before with my previous endocrinologists. We discussed my previous protocol (50mg twice weekly) that was responsible for my initial labs below, that the 677 range was likely supraphysiological for me since it causes acne all over my body, even in places I never knew one could get acne.

We agreed the high E2 is causing problems with mood, therefore periodic irritability/stress together with my 7 months long chronic cough is likely responsible for my elevated Reverse T3, so balancing estrogen is critical to bringing down Reverse T3 naturally because the main thyroid hormones are good. A1C is in has lots of room for improvement and IGF-1 is a little lower than Dr. Saya would like, so we discussed ​peptides, ipamorelin to increase growth hormone naturally.

I've been on a new protocol for the past 4 weeks, 16mg EOD (64 weekly) and noticed muscles were getting noticeably firmer after only the second week. Muscles are continuing to get firmer every week, muscles are stiff and sore 24/7 and that feel good burn you get after a workout is constant all without the workout. I went ahead and ran blood test at the 4 week mark (today) so Dr. Saya can dose the AI properly rather than going by outdated numbers from my old protocol. I don't plan on being on the AI for long, after I lose significant weight I'm going to stop it and see how I do.

My erections are starting up again as I draw nearer to the 6 week mark on my new protocol, testicles are tingling with sensitivity on and off throughout the day. I'm going to start berberine 500mg twice daily in place of Metformin since I have a negative reaction to it, coughing and hoarseness. Going to take fish oil daily as well. I'm going to try everything suggested without HCG for right now. We are going to reassess thyroid in three months and recheck thyroid with another full thyroid panel. We are also going to do a 4 point cortisol saliva test.

I'm very pleased with my consultation and look forward to my next check-in in 3 months to see what progress I have made.


Previous protocol = 50mg twice weekly.

Total T = 677 ng/dL 264-916 ng/dL


Free T = 29.2 pg/mL 6.8-21.5 pg/mL


SHBG = 16.2 nmol/L 16.5-55.9 nmol/L -->


Sensitive E2 = 70.6 8.0-35.0 pg/mLTSH .902 0.450-4.500 uIU/mL


Free T4 1.37 0.82-1.77 ng/dL


Free T3 3.6 2.0-4.4 pg/mL


Reverse T3 22.4 9.2-24.1 ng/dL


Thyroglobulin Antibody 1.1 0.0-0.9 IU/mL


Thyroid Peroxidase (TPO) Ab 10 0-34 IU/mL


Hemoglobin 16.7 13.0-17.7 g/dL


Hematocrit 48.8 37.5-51.0


RBC 5.58 4.14-5.80


DHEA-Sulfate = 224.1 - 71.6-375.4 ug/dL


Cortisol = 14.2 6.2 - 19.4 ug/dL


IGF = 153 67-205 ng/mL


Prostate Specific Ag, Serum 1.0 0.0-4.0 ng/mL


Magnesium, RBC 5.7 4.2-6.


 
Defy Medical TRT clinic doctor
I am sure it makes a world of difference mentally when you have confidence in your medical provider. I'm glad you came away from the consultation with such a positive outlook!
 
Id be very curious to see what you can pull on 16 EOD, I'm on 10mg/D myself right now. I have labs pending for 12mg/D right now. Even at 16mg my Free T was close to double the lab range. Will follow along with you and we're pretty similar in this way right now.
 
Id be very curious to see what you can pull on 16 EOD, I'm on 10mg/D myself right now. I have labs pending for 12mg/D right now. Even at 16mg my Free T was close to double the lab range. Will follow along with you and we're pretty similar in this way right now.

Well it isn't too good, 5 weeks at 16mg EOD I'm hitting TT 376 and FT 15.1, waiting on estrogen. I believe I'm going to do well somewhere near the top of the ranges for FT. Months ago when I was doing 20mg EOD I scored TT 524 two weeks into it (mandatory blood draw), I always thought I was headed up the ranges when those labs were drawn, but now I realize my levels were still falling from previously doing 25mg EOD that got me to 1000.

Since late last week I've noticed a gradual decline in how I feel, all improvements in the last 4 weeks are gone, I'm starting to feel like I did before TRT. I'm going in the wrong direction, waiting on Dr. Saya to advise me on AI dosing and Test dosage in the next 24 hours.

I can't wait to start the peptides, cost is slightly more than Test cypionate for 14 weeks.
 
I *thought* I could feel some decline at 10mg/D, negative sexual sides perhaps, but more than anything I noticed, coincidentally, that I started that 10mg and my R knee which is OsteoArthritic is popping when going down stairs which I take as a low E symptom. Something totally new.

These are my 12mg labs. Based on these and the feelings I have on 10mg, I switched back up to 14mg/D, today.

E LC/MS/MS = 14
Estradiol, Free = .44 (<=0.45)
Estradiol 20 (<=29)
TT 590
FT 160.7 (46-224)
SHBG 14
DHT 46 (16-79)
 
I *thought* I could feel some decline at 10mg/D, negative sexual sides perhaps, but more than anything I noticed, coincidentally, that I started that 10mg and my R knee which is OsteoArthritic is popping when going down stairs which I take as a low E symptom. Something totally new.

These are my 12mg labs. Based on these and the feelings I have on 10mg, I switched back up to 14mg/D, today.

E LC/MS/MS = 14
Estradiol, Free = .44 (<=0.45)
Estradiol 20 (<=29)
TT 590
FT 160.7 (46-224)
SHBG 14
DHT 46 (16-79)


The E/Free still intrigues me.
 
Awesome post, thanks for sharing. It will be interesting to hear your thoughts on the peptides, along with the feedback on your revised protocol as it progresses. Keep up the good work!
 
Beyond Testosterone Book by Nelson Vergel
Labs are in and while not out of range that's about to change. I want to point out that I did have high estrogen symptoms at the time (bloated) of this blood draw and considering my dosage is about to be increased an AI is even more important. I believe once I lose 50-60 pounds I'll be able to ditch the AI completely or greatly reduce it.

Total T = 376 ng/dL 264 - 916 ng/dL

Free T = 15.1 ng/dL 6.8 - 21.5

Sensitive E2 = 29.6 pg/mL 8.0 - 35.0

SHBG = 16 nmol/L 16.5 - 55.9 nmol/L
 
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