Need answers while I have the energy to do something about it...

[Gman86]

Hey guys,

I realized chasing a number is silly and there are a myriad of things the docs will consider. I've led a very stressed out life since childhood so I theorize that me cortisol, prolactin and surely estrogen levels are out of whack. I also take the point about free T and SHBG. But I still can't stop this question from running through my mind: My T has been so low for so long, what would it be like to have high T? That's where the number chasing comes into play I think.

I wish I knew how to post pictures. The contrast in me is unbelievable. I have well defined legs and arms but a giant gut. I look pretty ridiculous I think. I eat once a day, keto, do HARD cardio on the freestrider 5 days a week and lift 5 days a week. Still can't lose anymore fat or gain any strength. It's been so frustrating. I can't wait to see how a healthy level of test changes all that. Maybe I won't be a hard gainer/loser anymore.

I'm going to call both places here in about 20 minutes and I'll let you guys know how that goes. To be honest I don't really even know what questions to ask them and at this point I plan on going with whoever is willing to TRY to raise levels without TRT before we just jump on the full TRT train.

Just watched a Youtube video about a doctor talking about Keto. He says in his experience anyone on Keto will most likely lose muscle, or rarely maintain what muscle they have, unless they are on androgen therapy. Just something to consider for you. Keto is good for losing weight, and endurance activities, but not good for things like building muscle. Just something to consider. I'll link the video https://www.youtube.com/watch?v=RM0uMA0KXRA

Also, sounds like HRT is in your future. Have you had your free testosterone level checked? In regards to fertility, HCG mono would probably be a good first choice if you're secondary. Clomid could also be an option. I just personally had a bad experience with it, but then again I was on a high dose of 50mg/ day. Even TRT with at least 1,000iu's of HCG/ week with it can keep you fertile to a certain extent.

And ya, if you do need a clinic to help you, Defy Medical is the place I would personally go. Wish I would of found them years ago.

 

[Gman86]

So many variables and we are all different. Vince has higher Total T and has a ratio of Free T:Total T of 2.71% and my ratio is slightly higher at 2.85%.

Ya good point. My SHBG must be extremely sticky. Me and Vince have around the same SHBG, yet at his total T level he has a free T almost double the top end of the normal range, while when my total T was around his my free T was mid range. We are all very different, that's for sure.

 

[Vince]

Ya good point. My SHBG must be extremely sticky. Me and Vince have around the same SHBG, yet at his total T level he has a free T almost double the top end of the normal range, while when my total T was around his my free T was mid range. We are all very different, that's for sure.

The range that LabCorp uses account also for age, I'm 63.

 

[Fatboy]

Ok spoke to Defy, Prime and Dr Rands office. Before I continue with that I want to asks a question. Why do we know free T has to do with SHBG stickiness/levels and not some other limiting factor at play?

Prime: I left a voicemail unfortunately. I looked up some reviews though and it didn’t look totally promising.

Defy: Seemed great. He sent me a bunch of emails to get us going and told me I could get a physical done at Walgreens? I’ve never heard of this. But he also mentioned urgent care which seems legit to me. He also said that treatment will be about 1,500 per year which I’m satisfied with. 250 for initial consult and 284 for bloods from their lab. Do you guys find that annual estimate to be accurate?

PSR: I’ve seen Dr McClain on YouTube and believe him to be an authority on this issue, which I like. Am I wrong in that? She wasn’t sure of annual costs but the initial consultation with Rando is 800 and the 90 day follow ups are 200 if under 30 minutes. 400 for anything over 30 minutes. I’m not sure about the cost of the meds. The cost of the labs they want to draw is 350. They draw from the same lab as Defy so maybe the extra cost is in extra tests being run?

Both said they would be willing to try and treat with HGC and an AI of some type if I don’t want to jump straight to the needle but both were vague about that because I wasn’t speaking to the doctors themselves yet. PSR did say Dr McClain strongly dislikes clomid and more than likely won’t prescribe it. She said he is partial to Anastrosol. (Spelling?)

I’m already grateful for you guys pointing me in the right direction but if anyone is willing to answer the above questions and give me their thoughts in general about these options & new info provided please feel encouraged.

 

[ratbag]

Dr. Rand McClain is at DefyMedical and so is Dr. Saya and Dr. Caulkins all are very good hormone specialists. I'm surprised and confused there is a difference in costs with McClain since he works at Defy. Is there another Dr. McClain perhaps?
At $1500. a year I assume that includes all meds as well. Yeah it's a great price considering they are one of the best out there. There are TRT mills that charge $600 + a month. Clomid can have lots of sides and is used mostly to determine if you are primary or secondary and also good for restarts. What no one mentions is that clomid works best on younger men.

 

[CoastWatcher]

Dr. Rand McClain is at DefyMedical and so is Dr. Saya and Dr. Caulkins all are very good hormone specialists. I'm surprised and confused there is a difference in costs with McClain since he works at Defy. Is there another Dr. McClain perhaps?
At $1500. a year I assume that includes all meds as well. Yeah it's a great price considering they are one of the best out there. There are TRT mills that charge $600 + a month. Clomid can have lots of sides and is used mostly to determine if you are primary or secondary and also good for restarts. What no one mentions is that clomid works best on younger men.

It's my understanding that Dr. McClain maintains a separate practice at this point, based in California, and that his relationship with Defy is a very casual one and reflects the historical connection that was once in place. As in all things, I am open to correction.

 

[CoastWatcher]

Ok spoke to Defy, Prime and Dr Rands office. Before I continue with that I want to asks a question. Why do we know free T has to do with SHBG stickiness/levels and not some other limiting factor at play?

Prime: I left a voicemail unfortunately. I looked up some reviews though and it didn't look totally promising.

Defy: Seemed great. He sent me a bunch of emails to get us going and told me I could get a physical done at Walgreens? I've never heard of this. But he also mentioned urgent care which seems legit to me. He also said that treatment will be about 1,500 per year which I'm satisfied with. 250 for initial consult and 284 for bloods from their lab. Do you guys find that annual estimate to be accurate?

PSR: I've seen Dr McClain on YouTube and believe him to be an authority on this issue, which I like. Am I wrong in that? She wasn't sure of annual costs but the initial consultation with Rando is 800 and the 90 day follow ups are 200 if under 30 minutes. 400 for anything over 30 minutes. I'm not sure about the cost of the meds. The cost of the labs they want to draw is 350. They draw from the same lab as Defy so maybe the extra cost is in extra tests being run?

Both said they would be willing to try and treat with HGC and an AI of some type if I don't want to jump straight to the needle but both were vague about that because I wasn't speaking to the doctors themselves yet. PSR did say Dr McClain strongly dislikes clomid and more than likely won't prescribe it. She said he is partial to Anastrosol. (Spelling?)

I'm already grateful for you guys pointing me in the right direction but if anyone is willing to answer the above questions and give me their thoughts in general about these options & new info provided please feel encouraged.

Dr. McClain and Dr. Saya, the medical director at Defy, are close friends and respect each other very much (both have so stated here on the Forum). Dr. McClain runs his own Q&A here at Excelmale - go the Forum's front page and scroll down to find it. Then search Dr. Saya's name and read his contributions. All of us at Excelmale, whether patients of either of them, are fortunate to have their experience to draw on.

 

[ratbag]

Oh I see... I didn't realise this. Because I had seen this and assumed Rand was at Defy's

https://www.defymedical.com/about-us/our-team

 

[CoastWatcher]

Oh I see... I didn't realise this. Because I had seen this and assumed Rand was at Defy's

https://www.defymedical.com/about-us/our-team

I know he was "present at the creation" of Defy, but don't believe he is seeing patients through the Defy intake process. As I remind us elf all the time, I may be wrong...

 

[Gman86]

The range that LabCorp uses account also for age, I'm 63.

Oh very interesting Vince, I had no clue that some labs take the patients age into consideration in their ranges. Thanks for that info.

 

[MarkM]

LabCorp uses age ranges for Free Testosterone but not for Total Testosterone.

 

[Pumpiniron13]

Get another dr. Did he check shgb levels.? If not , some of your T could be bound in this homone and unavailable for body to use... just a thought

 

[30005Gator]

@Fatboy, I would HIGHLY recommend talking to Brandon Addison at Low T Nation.

I have NO affiliation with LTN, but highly recommend them.

I see that you've talked to Defy and Prime Body. I'd like to recommend you talk to Low T Nation as well. The CEO (Brandon Addison) is one of the most knowledgeable people in the US and teaches TRT treatment to endos and uros all over the world.


Don't let the name bother you...it's meaning is "we are a low T nation and we can help".


I was with two tele-clinics (won't name them, but one is mentioned in this thread) before finding and loving LTN. The other clinic I was with took forever to get labs, responses from the Drs/staff, etc. Their protocols are cookie cutter. The other was a disaster bc they blended arimidex with the testosterone and crashed my E2.


LTN is in Atlanta (where I live) so I went to their office to check them out (skeptical because of the name). Their office is top notch and is in Buckhead (a high end part of Atlanta). They really took their time walking through their program and I was thrilled to finally talk to a Dr who really gets it.


You'll be able to start IMMEDIATELY after getting a physical and labs (Defy has a 2-3 month waiting period).


Lastly, their pharmacy (Hallandale) screwed up my Rx and it didn't ship. Their office admin DROVE TO MY HOUSE to deliver a dose from their office supply.


It's a little more than Defy, but it's WELL WORTH IT!!

Here are some videos:
https://www.youtube.com/watch?v=Q9S-lDip86g&t=529s <-- fertility on TRT
https://www.youtube.com/watch?v=9DwUAy8F3RQ <-- choosing the right Dr


http://www.lowtnation.com
866-349-5698


Good luck!!

 

[Defy Medical]

One slight clarification to the thread. Our current wait time for all providers with the exception Dr. Saya is roughly two weeks. Dr. Saya's consult wait times are between 5-6 weeks.

We constantly look to improve this and to lessen wait times, but never at the expense of the consult time allotted with our providers and there is only so much time in the day.

I am happy to hear you reached out to us @Fatboy, please let us know if you have any more questions.

 

[user_joe]

If I were you OP I would run the necessary labs to paint the whole picture right now, freeze some sperm, and then proceed onto a TRT regimen with hcg at s fairly high dose, the hcg.

Do a sperm analysis before jumping on as well. No reason to freeze speed that's no good. If that's the case you need to let a fertility doc help fix the problem.

Seems like you sre are doing your homework and willing to self treat. Keep doing your homework. Most docs are not educated on this stuff.

 

[fatboyy]

Ok I’ve finally got my lab results back. I’m going to post them in a moment because some of the stuff is very perplexing to me. I’d like to know what stands out to you guys before I ask my questions.

 

[fatboyy]

Ok here are my labs. Currently waiting a response from Defy so if you guys could tell me what stands out to you I can get a list of questions ready for Dr Saya. Notice my total T went from 270 DOWN to 225 but free T is high...Anyways there’s a lot to consider I think?

 

[MarkM]

There are definitely numerous red flags on your blood work. Are you overweight?

Lymphocytes are high. These are a special part of your white blood cells. They tend to increase when we are sick or have an infection. Could just be temporary increase?

Glucose is twice the upper limit at 207. Have you had your A1C checked recently? Are you on diabetic medication? I am sure you aren't with glucose that high.

The lipid panel is terrible, especially the VLDL and the Triglycerides. I am guessing you are not on statins. Looking at your lipids and high glucose I'd have serious concerns about your diet.

I am really surprised your Free T came back at 26.5 when your Total T is only 225. One of those numbers appears to be wrong, I would guess it would be the Free T. Based on your Total T, SHBG, and Albumin, your more accurate Free T would be 4.62 and 2.05% of your Total T. I just can't see it being 26.5, however, a lot of your other numbers are way out of whack.

DHEA is high and over range but I don't really see that as a real issue. It surely isn;t making your Estradiol Sensitive too high. Your E2 is very low at 9.8. Since I am guessing you are overweight I would expect your E2 to me much higher.

IGF-1 is too low at at the very lowest of the range. SHBG is at 25.8 which is in the low normal range but like I said, E2 is very low at 9.2, almost completely blow the range.

Your Hemoglobin and Hematocrit are high especially if you are not yet on TRT. You will need to monitor that carefully.

How do you feel with your glucose and lipids where they are? I don't see any thyroid panel and based on what I am seeing in your blood work I would tend to believe your thyroid is not performing well. You really need a full thyroid panel to include: TSH, Free T3, Free T4, Reverse T3, and both thyroid antibodies.

I am no doctor and these are just my personal thoughts and what I would be concerned about.

 

[Vince]

My favorite thing to happen to me on trt is stabilizing my HCT. Even when I let my T levels run-up over 1500 my HCT stayed in a good range. It took me just over two years before it finally stabilized.

Another nice thing I've never had to deal with estradiol issues, which so many members have issues with.

 

[DragonBits]

Those doctors aren’t in my state, although I would rather have pharma grade stuff with doctors supervision I’m afraid I’m going to have to do this myself. My doc won’t do anything or refer me anywhere. My fiancé is a nurse and is extremely supportive. So if I can’t get treatment I at least have her as a resource.

So I am definitely still seeking a doc but I’m still curious if this protocol would work well for 2 reasons. First I don’t want exo T if I can avoid it but I also don’t want to go to a doc requesting something that is simply ineffective. Second if I can’t affordably and realistically get treatment I will do it on me own. I think it’s imoortant for me to keep in mind that being low T also loses significant risks. I can’t be complacent about it anymore. One way or the other I need a result and I want to make sure I have ALL my bases covered.

Your use of marijuana may be hurting your sperm count. You can get a free sperm analysis by going to a fertility clinic, often they advertise a free analysis. Just don't sign up for additional fertility help, it's always expensive. I think you do need to go in as a couple.

You can also buy a cheap microscope and check your own sperm out.

It sounds like HCG is the best option, I don't know why you want to suppress your estrogen as the drups you mentioned seemed to be about estrogen. They aren't going to do anything for testos.

Neither is SR9009, "also known as Stenabolic, is a synthetic drug created to study the circadian rhythm. It was shown to boost endurance, reduce anxiety, and decrease cholesterol, weight, and inflammation in mice. These effects, if proven in humans, would replicate some of the beneficial effects exercise has on our bodies and thus, improve our health. However, although available as a supplement online, it has not been tested in humans and its side effects are still unknown. "

I agree with others, you shouldn't have a TT number as a goal since you have no idea how much energy or how good you would feel at a TT of 600, 700, etc. More doesn't help you unless you are a body builder, and more always comes with greater side effects.

===============================================

Another study published in the American Journal of Epidemiology found that using marijuana more than weekly, along with other drugs, contributed to a 55 percent total sperm count reduction.

It also found that that marijuana use increased testosterone production. It should be noted that using other drugs could have an effect on this study’s results.

https://hightimes.com/health/cannabis-affect-hormone-levels/