Advise on clinics

Jsteven

New Member
I need help sorting through all the online clinics I have been looking into royal medical centers can someone please help me are they worth it and are they good clinic to join thank you for any advise
 

slicktop

Active Member
Start with where you're located. Won't do us any good to recommend something not in your country.
 

Vtail

Active Member
I was with DEFY for about a year and they were great. I left because my PSA was creeping up above 4.0 and they put my treatment on hold until I was cleared by a urologist. I found a urologist that was up to speed on TRT, so I stayed with him.
 

Jsteven

New Member
I was with DEFY for about a year and they were great. I left because my PSA was creeping up above 4.0 and they put my treatment on hold until I was cleared by a urologist. I found a urologist that was up to speed on TRT, so I stayed with him.
Thanks for advice
 

VacationMan

Active Member
Thanks for advice
Oddly enough, I just kicked a urologist to the curb and transferred my TRT to Defy (they were just helping me with HCG). Urologist wouldn't prescribe HCG at all (hence the reason I reached out to Defy). Urologist didn't know enough to check E2 and other important metrics - just relied upon total testosterone and total estrogen, with an occasional PSA test tossed in. Wouldn't even consider changing his protocol either.

One born every minute (poor urologist). Defy has done a wonderful job for me...and it's worth having to pay for compounded testosterone rather than getting it through an insurance co-pay.
 

Joe Sixpack

Active Member
I was with DEFY for about a year and they were great. I left because my PSA was creeping up above 4.0 and they put my treatment on hold until I was cleared by a urologist. I found a urologist that was up to speed on TRT, so I stayed with him.
What are you and your doctor doing about the elevated PSA?
 

Systemlord

Member
I used Defy in the past and continue to do so and knowledge among the doctors there are significantly higher than any doctors within my healthcare provider.
 
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Vtail

Active Member
What are you and your doctor doing about the elevated PSA?
A prostate MRI came back all-clear. The urologist was satisfied, especially since I have no symptoms that would indicate there is a problem. The timing of everything leads me to believe that TRT caused my PSA to elevate. Although it could have an age related component as well - I am 57.
 

VacationMan

Active Member
A prostate MRI came back all-clear. The urologist was satisfied, especially since I have no symptoms that would indicate there is a problem. The timing of everything leads me to believe that TRT caused my PSA to elevate. Although it could have an age related component as well - I am 57.
I'm 58 and have been on TRT for the last 8 years. Connected with Defy back in 2017 because of testicle atrophy and they put me on HCG at that time. All good now!

To add insult to injury, I have Hashimotos - have to take T4 and T3 meds daily to keep that under control. My PCP does all the blood work because my insurance pays 100% on labs. I take a list to the doc with the test and CPT codes and she places the orders. I get a copy of the labs, scan 'em in and share with Defy for my follow ups there. $20 office visit co-pay and I'm good to go.

At my last 6-month blood work checkup, I had something similar happen to me. Everything came back normal except PSA. My PSA level came back elevated at 4.7 and I normally gauge 1.2 to 1.7 at most - always under 2.0. Zero symptoms too. PCP had me come back for another blood draw a week later and my PSA was back to normal at 1.4.

After discussing this with my PCP and with the PA at Defy, we came to the conclusion that a romp in the sack soon before blood work can elevate PSA. That's the only plausible explanation we could come up with. PCP is perplexed as to why I don't have prostate issues. Big secret: That particular gland needs to be thoroughly emptied on a regular basis to prevent prostate issues. At least that's the excuse I use with the wife! ;-)

Only one other time that my PSA was elevated: The time I tried scrotal application of testosterone cream. While that therapy helped bring DHT into range, it also spiked my PSA above 5.0. I discontinued the cream and PSA returned to normal within a couple of weeks.

Just my experience...
 

swoops36

Active Member
I need help sorting through all the online clinics I have been looking into royal medical centers can someone please help me are they worth it and are they good clinic to join thank you for any advise
I think royal is the one that includes the AI in their compounded test, and should be avoided at all cost
 

Jsteven

New Member
I think royal is the one that includes the AI in their compounded test, and should be avoided at all cost
Why is the AI thing bad , I'm thinking to go with defy I'm worried bout paying all the money then be denied because levels aren't low enough even though I have almost all the symptoms I'm 41 and always heard I'm not old enough for testosterone treatment
 

Systemlord

Member
I'm thinking to go with defy I'm worried bout paying all the money then be denied because levels aren't low enough even though I have almost all the symptoms I'm 41 and always heard I'm not old enough for testosterone treatment
Defy doesn't play the numbers game, they also consider the symptoms and if they believe your issues are related to something else, they will investigate and attempt to address it.

I remember once Defy gave a guy TRT with FT at 18 pg/mL (FT ranges 10.8-25.6) because they suspected androgen resistance.
 
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swoops36

Active Member
Why is the AI thing bad , I'm thinking to go with defy I'm worried bout paying all the money then be denied because levels aren't low enough even though I have almost all the symptoms I'm 41 and always heard I'm not old enough for testosterone treatment
The AI isn’t a bad thing necessarily, it’s the inclusion of it into the test mixture. Makes dialing in one drug dependent on the other. Keep them separate
 

slicktop

Active Member
Why is the AI thing bad , I'm thinking to go with defy I'm worried bout paying all the money then be denied because levels aren't low enough even though I have almost all the symptoms I'm 41 and always heard I'm not old enough for testosterone treatment
I started with Defy at 41, so don't worry about that. As previously mentions, symptoms are always more important than numbers with Defy, but more important than that, Defy is looking for ways to *optimize* your health, instead of shrugging their shoulders at a lab result and saying "well, you're within range".

Regarding the AI, there's not necessarily anything wrong with it, but most men and most good practitioners will guide you towards finding a protocol that works best with the least amount of medicine FOR YOU. I took a f-ton of anastrozole my first few months of TRT and really needed it to adjust; these days I barely take any and I genuinely feel better at 43 than I did at 33.
 

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