First Consultation with Defy

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croaker24

New Member
We went off my blood tests from a month ago (non-Defy.) I will have another test in 3 months. So the baseline is, currently doing 50mg 2x a week for 100 mg total.

Total

957 ng/dL

DHT

117 ng/dL

Estradiol Sensitive

38.2 pg/mL

SBHG

55.6 nmol/L

Free

16.6 pg/ML




a) Defy suggested that I move to 120 mg a week (60mg 2x) to try and get my free higher and lower my SBHG. I'm a little apprehensive about this - in what it will do to my estradiol and total T (although he explained the free is the more critical # and not so much the total.) Discussed estradiol management and I brought up the ratio paradigm discussed by Nelson. Defy explained that they go by symptoms more than just the numbers.

b) Is there such a thing as "free estrogen" or "free estradiol"? Or a misunderstanding on my part.

c) Suggested that my b12 number (507 pg/mL) could be better. I do eat primarily vegetarian with fish about 3 or 4 days a week. While I take a b12 supplement, not sure how much good it is doing me. Discussed b12 injections or Lipo-C. I hate injections. Doing 2 a week for my cypionate is awkward enough.

d) Discussed HCG. Discussed saw palmetto (due to elevated DHT) as alternatives.

e) Red blood cells counts under control. PSA under control. Ferritin/iron on the low side but I had a case where I had a major brain fart and donated twice in 3 months and gave a lot of blood for a blood test in that same period, causing my ferritin dropped to 8. This was about 9 months ago. My ferritin is at 19 now but I had just donated in April. Just need to stay away from donating blood unless necessary for hematocrit management, but I have a rare blood type and I am constantly badgered to donate.

All in all - a good first consultation and I'm encouraged. Just concerned with moving to 120 mg a week but again, I've been on 100 mg for a year now.
 
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Robbie63

Member
I would not be overly concerned with high total, especially if your not experiencing negative side effects. You can always make a readjustment to any dosage change. Everyone is different at where you feel your best.
 

croaker24

New Member
Coast -

Both my estradiol and free-t have been gradually increasing. My estradiol had been steady in the low 20's, then started going up while my SHBG and Free T has slowly been decreasing.
 
Coast -

Both my estradiol and free-t have been gradually increasing. My estradiol had been steady in the low 20's, then started going up while my SHBG and Free T has slowly been decreasing.

How much hcg are you going to be taking now vs before? This also is a player in estradiol. Im sure you are going to be in great hands with defy. I'm recently with them after years with another clinic and have no regrets!
 
Croaker- Vitamin B12 can be mixed with your testosterone injection. It does not have to be taken frequently as B12 stores in the body well. 1ml per month improves and maintains most. It can be taken once per week for more aggressive dosing. If you got room in the syringe along with cypionate, try adding .25ml methylcobalamin twice per week. Or you can take 0.5ml-1ml every 1 to 2 weeks subq.
 

croaker24

New Member
How much hcg are you going to be taking now vs before? This also is a player in estradiol. Im sure you are going to be in great hands with defy. I'm recently with them after years with another clinic and have no regrets!

Not taking any HCG at the moment. It was discussed as an alternative with Defy. The initial consultation was a review of my blood tests, and some ideas floated for me to consider. I broached the topic of HCG with my previous provider and they kind of dismissed the idea.

I'm cautiously optimistic about Defy. I *hate* taking any medication or supplement. I will only do so if a lifestyle change does not work and only after considerable research into safety and long-term effects. I've been burned in the past by medications that has caused considerable damage so I tend to distrust all doctors.

The only reason I'm on TRT is because my overall T dropped to the 130's and it was never determined why this happened.
 

croaker24

New Member
Croaker- Vitamin B12 can be mixed with your testosterone injection. It does not have to be taken frequently as B12 stores in the body well. 1ml per month improves and maintains most. It can be taken once per week for more aggressive dosing. If you got room in the syringe along with cypionate, try adding .25ml methylcobalamin twice per week. Or you can take 0.5ml-1ml every 1 to 2 weeks subq.

Thanks Jasen. My plan is to try lifestyle changes first - e.g. - review my B12 supplement - and I'm well aware of the lower absorption rate - review my diet, etc. And then assess the trend over time. I really would like to wait until the next blood test to give Defy time to understand "me* as a patient. One consultation is just a snapshot of where I am now, but not tell us where I'm trending. Furthermore, I do not like making more than one change at a time - otherwise how do you assess what helped or what hurt? I started with the increased dosage today as recommended in yesterday's consultation.
 

croaker24

New Member
Exactly what does lowering SHBG and raising free testosterone does for me? I feel pretty good consistently these days. I know my SHBG is a little high and my free T is on the low side but what is the impact?
 

Vettester Chris

Super Moderator
Keep us posted with your progress. My .02 on your labs, I think your SHBG could stand to come down just a bit (or call it your free test to come up a bit) ... Many times you will tend to see a deficiency in Vitamin D3 when SHBG is elevated (not always, but sometimes). I'd suggest taking a look at yours, and if deficient talk to Defy about your options?!?!
 
Exactly what does lowering SHBG and raising free testosterone does for me? I feel pretty good consistently these days. I know my SHBG is a little high and my free T is on the low side but what is the impact?
Free or bioavailable T is what is in the bllod for the body to use. When T is bound to SHBG it just floats through unused. Free T is what you want good numbers on and high SHBG means a lot (more) of the Total T is not usable.
 

croaker24

New Member
Free or bioavailable T is what is in the bllod for the body to use. When T is bound to SHBG it just floats through unused. Free T is what you want good numbers on and high SHBG means a lot (more) of the Total T is not usable.

Thanks Vince - but - what is the impact? Will it make one feel differently in any way, mentally, emotionally, physically?
 
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