Newbie starting TOT

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TDCNINJA

Member
Hello everyone.

I'm a 53-year-old, obese male who has many of the classic low-t symptoms. Difficulty in obtaining/maintaining erections, constantly irritable, have a hard time getting to sleep, maintaining sleep, brain fog, poor memory and difficulty concentrating.

I read Jay Campbell's book and found out about Defy Medical. I paid extra and got some of the other tests in addition to the standard tests in order to get a baseline in the event that a physician wanted to prescribe medications/supplements.

Here are my key numbers

Total Testosterone: 332
Free Testosterone: 3.8 (LOW)
SHBG: 42.2
Estradiol (Sensitive) 19.9
DHT: 20 (LOW)
DHEA: 169.4
LH: 5.1
Prolactin: 10.3
Pregnenolone, MS: 39
PSA: 1.3
IGF-1: 100
T4 Free 1.37
T3 Free 3.1
TSH 2.930

A few days after getting my test results, I had a consultation with an Advance Practice NP at Defy and he prescribed the following:

T Cyp 200 mg/mL – 0.35 mL (70mg) IM/SQ twice a week.
HCG 500 IU SQ twice a week. To reverse/prevent testicular atrophy. Increase Free T.
Anastrozole 0.125 mg one by mouth twice a week. Hold for the first 4 weeks, then as needed. PRN per elevated E2 symptoms
DHEA 25 mg one by mouth every night. To Decrease SHBG and Raise Free T.
NDT 0.5 Grains (30 mg) (or T3/T4 equivalent 4.5/19 mcg) - One by mouth every AM, for two weeks. Then can increase to 1 Grain (60 mg) by mouth every AM, for two weeks. Then can increase to 1.5 Grain (90 mg) by mouth every AM, for two weeks. Then can increase to 2 Grain (120 mg) by mouth every AM, for two weeks. Can continue to titrate 0.5 Grains (30 mg) in intervals of 2 weeks or longer, per benefit and tolerance as discussed, STOPPING at a maximum of 3 Grains (180 mg). Stop titration if any hyperthyroid symptoms occur and go back to the previous dosage starting the next day. Take first thing in the morning upon waking, on empty stomach, at least 30, preferably 60 minutes before breakfast.
GABA Injectable, 10mL 100mg/ml inject 0.25ml-0.5ml every night. PRN - helps with sleep.

I am a strong believer in the concept of minimum effective dosing as well as the old adage "go low, start slow."

I absolutely disagree with supraphysiologic dosing unless it proves the only way to raise T. Therefore I informed the provider of my intention start very low and then work up. I also informed them of my desire to inject daily, subcutaneously. I sent a message via email to them to ask them if I can also change to T-Propinate.

Once my medication arrives from Empower Pharmacy, I will begin injecting 10mg of Test daily, subcutaneously. Once I conduct follow up testing my provider and I can adjust.

I know that many of you on this forum are extremely knowledgeable and I know nothing about T and am just starting out. However, I'm the one who has to live with my decisions as well as being able to sleep at night.

Based on my research, I feel that daily subcutaneous administration of T results in many added benefits such as more stable serum levels of testosterone, lower estradiol levels and most closely mimics natural physiological production of testosterone.(especially if used with T-prop) I also believe that this method is safer in terms of adverse events.

In the end, I can always increase my levels after follow-up lab testing.

I'm very impressed with the knowledge on this site and happy to be a new member. I will post my results and issues as they arise. Mostly, though, I will just read and learn.

Thank you in advance for any information that you can pass along to me about my numbers and/or plans.
 
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Systemlord

Member
It's not at all common to see someone new to TRT well educated and wanting to start out on daily injections, excellent. I attempted 7-10mg daily injections and for one reason or another my body didn't exactly like it much, strange skin issues but in other areas felt amazing.

Beside your obvious low testosterone levels and while your thyroid didn't look dreadful, TSH was indicating it wasn't happy with the amount of thyroid hormones in the body. It's important for thyroid hormones to be optimal to get optimal results from TRT.

IGF-1 is low, have you considered peptides to increase your natural production of GH/IGF-1?

There are many members here who are with Defy Medical, myself included. I hope to see you regularly update your process and to see you contributing this great forum.
 

TDCNINJA

Member
It's not at all common to see someone new to TRT well educated and wanting to start out on daily injections, excellent. I attempted 7-10mg daily injections and for one reason or another my body didn't exactly like it much, strange skin issues but in other areas felt amazing.

Besides your obvious low testosterone levels and while your thyroid didn't look dreadful, TSH was indicating it wasn't happy with the amount of thyroid hormones in the body. It's important for thyroid hormones to be optimal to get optimal results from TRT.

IGF-1 is low, have you considered peptides to increase your natural production of GH/IGF-1?

There are many members here who are with Defy Medical, myself included. I hope to see you regularly update your process and to see you contributing this great forum.

He prescribed NDT 0.5 grains (30mg) to address my Thyroid issues with the ability to titrate up to a maximum of 3 Grains (180 mg)

I asked about Sermorelin and Ipamorelin and he advised me to wait until after my first labs before adjusting. I wish that I could afford Tesamorelin (Egrifta).
 

NoHablo

New Member
It sounds like you are well on your way to getting your arms wrapped around your Low T, Thyroid, and Adrenal issues. As you are well aware, there are lots of moving parts here and the learning curve can be quite steep at first. However, at some point, what seemed overwhelming, begins to slow down quite nicely as your understanding firms.

That said, I would encourage to begin, if you haven't already, wrestling with the other two legs (hormones being the first) of this three-legged stool: diet (what you eat) and exercise (strength training and cardio). As your energy and will increase, due to HRT/TRT, this will become less of a challenge. Start now (with the support of your doctor). "Go low and slow" works well here too!

Godspeed my friend !!
 

Systemlord

Member
I wish that I could afford Tesamorelin (Egrifta).

It may be worth it to wait and see because sometimes we see TRT can increase IGF-1. I tried Ipamorelin and it did nothing. Tesamorelin is currently the most effective GH releasing hormone on the market, out of my reach financially.
 

Tednacious73

New Member
It may be worth it to wait and see because sometimes we see TRT can increase IGF-1. I tried Ipamorelin and it did nothing. Tesamorelin is currently the most effective GH releasing hormone on the market, out of my reach financially.
Just an FYI to the OP, my IGF increased from 159 to 272 after being on the same protocol from Defy after 3 months (minus the thyroid medication)
 

TDCNINJA

Member
When I was a young Infantry soldier, we used to have a saying directed at some of the other MOS branches that went "Everybody wants to be Infantry until its time to be Infantry."

Fact is I'm scared to death to begin my injections. Guess its time to man up.
 

TDCNINJA

Member
The box from Defy/Empower is supposed to arrive tomorrow. I think I'll wait until Monday to start. Might try the Gaba early though, to see if it helps with sleep
 

Systemlord

Member
The box from Defy/Empower is supposed to arrive tomorrow. I think I'll wait until Monday to start. Might try the Gaba early though, to see if it helps with sleep

Make sure you let the alcohol dry before doing the injecting or else it will sting. Don't delay recovery, maybe you can have someone assist you.
 
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