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I am looking for a recommendation for a TRT clinic with knowledgeable staff, ideally one that practices telemedicine. I have been having issues with Defy, but realize it's inappropriate to post details here... so if someone would be so kind as to PM me and let me know of alternatives, I would be...

No time for a prolonged update now, but the problem was SR Liothyronine, as I had suspected. I skipped the second dose right after the last post and went straight for 5mcg of the Liothyronine drops I had been using before. Within just 15 minutes, all symptoms disappeared and I was back to...

I feel obligated to post an update here, even though it's not a positive one. Over the past three weeks, I've followed Defy Medical's advice and cut my T Cypionate dose in half and switched out the Liothyronine drops I had been using for Sustained Release capsules from "Empower" Pharmacy...

I wish I could say it's E2, but that SHBG is a huge problem. It was the main reason I was started out on such a high dose (supposedly to overcome binding and get better free T). The last lab shows a high free T, but SHBG shot up again (along with RT3). Doing two ultra-sensitive E2 tests would...

Which begs the question: why isn't sub-Q administration advocated more if it is just as effective as IM? Or is there an issue with absorption?

For anyone that's interested in following this research with me, here is the article I came across before deciding to start Prog + DHEA: 6-Ketoprogesterone and its biological actions The results are summarized in Table 6. If you go far enough down this rabbit hole, you'll find that this...

I wanted to wait a few days before posting an update, to assess things more thoughtfully. I had a consult with Defy last week. I didn't have an opportunity to speak to a doctor, just a knowledgeable PA, but he seemed to have a few more "angles" on the matter than my current practitioner. He...

Time for an update. TL;DR -- I'm in a black hole of complete emasculation with a total T / free T to die for. I had a good run with 5mg Progesterone / 5mg of DHEA per day. Libido was on the rise, and energy levels seemed to be improving. All that came crashing down about a week ago, when I got...

This is right on the money and in line with what I have been thinking about these pathways. Last night, I took 5mg Progesterone + 5mg DHEA in tocopherol. Everything went back to normal and I feel perfectly balanced today. Nothing remotely like yesterday. Too much DHEA is, indeed, a bad thing...

Things have been taking a sinister turn for the worse lately. I went into the provider's office yesterday for a follow-up, and they put a transcranial EEG helmet on my head and asked me to respond to sounds, draw paths through numbers, and other such nonsense. From this, they deduced that I an...

My thoughts exactly. They are underfilling the tube on purpose and charging extra for it. It's too bad EmpowerRx doesn't having anything of that strength (they declined to send me a quote). Yes to the Sensitive E2 test. Been wanting to do it for a while, but it's hard to break away to the lab...

I started out with the TopiClick, but 4 clicks didn't seem to yield enough cream. 1g from the tube I have is about 3-4 times more than 4 clicks, but it only lasts 3-4 weeks and costs $339. The bigger issue here is that I'm under rather incompetent care. The doctor is a gynecologist over 85. When...

I called EmpowerRx this morning --- sent them a copy of the script. Apparently, they can't do it. They only have the TopiClick and no where near the dose I take (400mg / day).

200mg 2x a day. And yes, I suspect free E2 is low. I've been experiencing penile shrinkage, stiff joints, and other unpleasant things. Nothing like high E2.

It's not a TopiClick but a tube with a plastic syringe. I measure out 1g (which is 200mg) and put that on the scrotum. It's far, far more cream than 3-4 clicks on the TopiClick were producing. I'm getting a total of 400mg a day. This particular provider is a Rouzier devotee. He doesn't worry a...

Nope. Regular E2. Sensitive assays in the past have hovered around 9-10, but that was before T therapy. Update on the Prog/DHEA combo --- as of today, it's starting to produce low E symptoms (stiff joints, erectile dysfunction, etc.). So I'm thinking that it probably had temporary good effects...

Thanks for pointing that out. I mistyped. Let me go back and correct it.

The problem with the thyroid labs is that they are hard to interpret in isolation. You made a passing remark about low cortisol and high DHEA, but would you mind sharing some specifics? For example, what kind of cortisol measurement was it? If it was a 4-point salivary measurement, did it show...

This is a re-post form another thread, but wanted to get opinions here as well. I beginning to think my provider is performing a wallet biopsy on me. They are giving me a 90G tube of cypionate liposomal cream at 200mg/G. They are charging $339 and asking me to apply 1g to the scrotum 2x a day...

Reading this thread, I beginning to think my provider is performing a wallet biopsy on me. They are giving me a 90G tube of cypionate liposomal cream at 200mg/G. They are charging $339 and asking me to apply 1g to the scrotum 2x a day. I've been doing that but am already running out of cream on...

I don't follow you. I'm using Progesterone / DHEA now. No Pregnenolone. Completely different combination with completely different effects. "Round and round" would tend to indicate going no where. Improvement is not a circle. Sorry, try again.

Docs never understand my thyroid numbers. I'm a clinician myself (non-MD category), and I look at things from the "functional" perspective, so when they say things look fine or that NDT is required to bring things in line, I always question their reasoning. Back in the early days, I tried .5...

You know, I slept on this one and woke up this morning feeling that I would just forego AI for now. I intuitively feel that my primary issue is high adiposity and suboptimal thyroid. I did an InBody 230 measurement in the doc's office before starting therapy. It showed lean body mass at 172.9...

I've been away for a while researching options. Ultimately, I decided to start testosterone therapy, but it has only made matters worse. Let me explain: I started with IM injections of cypionate, 100mg 2x a week. After frequently hitting nerves in all the recommended injection sites and...

Back while I was doing that, I was going for about 5 minutes, 3x a week, never two days in a row. That seemed to be enough to stimulate T production. These days, my SHBG is so high, it no longer works.

The anti-aging community puts optimal male estrogen at 20-30, though it's very individual. Some men feel awful with 20 while others thrive at that level. Mine is at 9 (using the sensitive assay), and I am concerned that Clomid could cause issues from blocking the effects of what little estrogen...

I failed to mention that I have been looking at HCG monotherapy. I have heard that it may not be as effective at overcoming the high SHBG, but I am still sticking to the idea that estrone is pushing that up.

The thyroid problem is rather complicated. I have some unique immunological issues and multiple viral infections that I'm constantly suppressing with diet and lifestyle. There is the problem of inadequate secretory IgA levels (confirmed on labs), which is easy to fix in the gut, but not so much...

Please help me understand where I am off base. I happen to be a clinician, so while my understanding may not be optimal, I've looked at enough labs (both my own and others) to see patterns. The estradiol listed above is the (inaccurate) Roche ECLIA method that Life Extension uses. I have...

Thank you for the input. My apologies if I wasn't clear about it, but I did measure DHEA-S (blood serum) while taking absolutely nothing, and it came out to 186.6 ug/dL (102.6-416.3), near the bottom of the range. The 2486 shown in the graphic is from a 24-hour urine metabolite test (Rhein...

This will be my first post here. I have suffered symptoms of low T for quite some time, and I have been consulting with various hormone experts trying to understand my steroid hormone metabolism more deeply. I won't name names, but I keep hearing "there is nothing you can do about this, and...