New to ExcelMale - appreciate answers/feedback

[dt74]

Glad to have found this forum.

Intro
I am 45 yrs old, 6' tall, and 295 lbs - married (3 great boys). I put on about 80 of that in the past 4 yrs. Besides the weight gain, I have (had) lost vigor in my many aspects of my life (home, work, & general personal motivation). I had also become annoyingly irritable. Along with starting TRT, I am making some significant changes to diet and behaviors.

Goals

• Lose about 100 lbs
• Improve overall health, strength, and stamina
• Regain energy and focus
• Improve mood
• Improve sex life

Diet
For 2 full weeks now, I have been eating very clean. Ton of vegetables, no sugar or processed carb laden food. Chicken broth and healthy protein. I have also begun most days with collagen in hot tea (only intake for the first 1-2 hrs of the day).

Exercise
Still finding a routine with this (also 2 full weeks in with this). I have a few free weights and bench, so I have been lifting 3-4 times a week. I did a 100 flights of stairs in my house for cardio the other day and went mountain climbing this past weekend. I need find a good routine in the space - suggestions & links are welcomed and appreciated.

TRT - just entering week #2
I am working with a "men's clinic." Any pro's/con's on this are appreciated. I am not kidding myself...I knew that they would be overpriced and probably a bit more willing to stretch the boundaries.

They took blood in the office and measured 3 things (@8:30am - fasting):

• Total Testosterone: 402
• PSA: 0.45
• HGB: 15.9

Testosterone Cypionate Compounded in Grape Seed Oil 200mg/ml 5ml vial.

I was given a 1.0 ml shot in the office (7 days ago).
I was prescribed to pin 0.6 ml once a week for the first 6 weeks (then a full set of labs will be done).


Questions
1) How to decide if I pin at 8pm or 8am? Does it matter at this point in my personal situation?
2) Suggestions for an exercise routine to lose weight, gain strength, and feel better?
3) Thoughts about working with a "mens clinic" vs a traditional Primary Care Physician?
4) My HGB number is a little high. I am currently eating tomatoes (2-3 servings every other day). Tomatoes are a natural blood thinner. Thoughts on this and being at the upper range of HGB?
5) Any other comments or thoughts about my download above?

Thanks everyone!
DT

 

[Vince]

Did you have more labs done?

Blood Tests Needed Before and During TRT

Proper monitoring of men on testosterone replacement therapy has been dictated by several medical guidelines groups. However, most of them fall short in guiding doctors on what to do if different key variables are not optimal. The following list includes all important blood tests and health...

www.excelmale.com

 

[dt74]

Hi @Vince - No, those were the only labs. I was told they did a full work up at 6 weeks.

 

[Vince]

Hi @Vince - No, those were the only labs. I was told they did a full work up at 6 weeks.

It would have been nice if they would have did full Labs before you started trt. You don't know if you have primary or secondary hypogonadism.

 

[Vince]

Do I Have Primary or Secondary Hypogonadism or is it Thyroid?

To be clear, my doctor's never diagnosed me as hypgonadal because my Total Testosterone has never been below 300. However, I'm 42 years old and for at least of a handful of times over the years in my 30's I have never tested over a 396 in my Total T. I've consistently been in the 323-396 range...

www.excelmale.com

 

[fifty]

Pin in the AM

 

[dt74]

Do I Have Primary or Secondary Hypogonadism or is it Thyroid?

To be clear, my doctor's never diagnosed me as hypgonadal because my Total Testosterone has never been below 300. However, I'm 42 years old and for at least of a handful of times over the years in my 30's I have never tested over a 396 in my Total T. I've consistently been in the 323-396 range...

www.excelmale.com

Thanks for sharing this.

 

[slicktop]

Questions
1) How to decide if I pin at 8pm or 8am? Does it matter at this point in my personal situation?
Most men have a natural peak in the morning, usually around 10AM. If you're doing weekly shots though, I can't imagine it'll make much of a difference.
2) Suggestions for an exercise routine to lose weight, gain strength, and feel better?
Bigger Leaner Stronger by Mike Matthews. It literally changed my life.
3) Thoughts about working with a "mens clinic" vs a traditional Primary Care Physician?
Don't. At least, not one of the "drive through" ones. I have a longer rant that I'll spare you from, but basically they charge men anywhere from $75-100 for about $5 worth of testosterone and force them into what is most likely a sub-optimal dosing schedule and frequency.
4) My HGB number is a little high. I am currently eating tomatoes (2-3 servings every other day). Tomatoes are a natural blood thinner. Thoughts on this and being at the upper range of HGB? No clues. Sorry.
5) Any other comments or thoughts about my download above?
Please consider going through your PCP or Defy Medical moving forward. Any clinic that makes you come in for a weekly shot is the testosterone version of a pill mill. Going through your PCP may be harder at this point since you've now started at a clinic. He may want you to stop completely, get a new blood test (maybe two, who knows?), etc. If cost is a primary concern (which I'm assuming it's not since you're literally doing the most expensive thing possible right now) your PCP will likely be the most cost effective route, although the level of care and expertise can vary greatly. Testosterone is cheap, even without insurance picking up the tab (goodx coupons get the price down significantly). Many PCPs want nothing to do with anything other than testosterone though, so ancillaries can be an issue. If your PCP is cool though, and willing to work with you and let you take part in your care decisions, and will treat your symptoms not just your numbers, that's a very good way to go. From what I've heard from the men on here though, that's a long shot typically to get all those things out of a PCP.
Personally, I switched to Defy from my PCP for two main reasons. First, my doc, while very cool about starting testosterone, was more of a "lets wait and see" kinda guy and I'm more of an interventionalist. For example, when I started testosterone initially, my body basically over-reacted to it and my estrogen shot into the 90's, and he wanted me to stop for a month and then restart on a lower dose, as opposed to giving me an AI so I wouldn't feel like crap and lowering the dose gradually. He also didn't want to do HCG, which I very much wanted to incorporate. Defy, however, does cost me a little more than going to my PCP, but they take a much deeper look at my full blood panel (and everything else, FWIW), they prioritize my symptoms over my numbers, and I get great care out of them. They even started my on nandrolone after a nagging shoulder wouldn't heal up on its own, and honestly nandrolone has been a game changer.
Longer response than I intended, sorry. I just have a thing against the drive-throughs and I've been very pleased with Defy.

 

[dt74]

@slicktop - Thank you very much - great reply. I will look into Bigger Leaner Stronger.

Regarding the clinic I have initiated with, they gave me a script and I am pinning at home. I believe they are better than a drive through and the reviews I found are pretty good. They did spend 2.5 hrs with me on my first visit. I just now wish they had done a more thorough baseline. I will reach out to Defy and discuss what a "transfer" might entail - there seems to be a lot of positive feedback about them.

 

[slicktop]

If you're pinning at home, that's a good sign. It's the places that want you to come in to the office for a weekly $100 visit that scream "t mill!". I'm sure you'll come across plenty of posts, but since you're already doing your own shots, you might want to seriously consider going to every 3.5 days as it results in much more even levels.

 

[Mary-Defy Medical]

@slicktop - Thank you very much - great reply. I will look into Bigger Leaner Stronger.

Regarding the clinic I have initiated with, they gave me a script and I am pinning at home. I believe they are better than a drive through and the reviews I found are pretty good. They did spend 2.5 hrs with me on my first visit. I just now wish they had done a more thorough baseline. I will reach out to Defy and discuss what a "transfer" might entail - there seems to be a lot of positive feedback about them.

If you have any questions regarding Defy Medical and transferring treatment, you're welcome to contact me directly. I'd be happy to help. My email is [email protected] !