90day bloodwork w/Defy-tweaks?

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lukdiver

New Member
Hi: Posted on Blood Test Discussion page (https://www.excelmale.com/forum/showthread.php?15109-90day-bloodwork-w-Defy-tweaks ) and posting here to get feedback on possible questions for the Defy nurse Christie June 29. My history prior to Defy I covered in a Intro posting (https://www.excelmale.com/forum/showthread.php?13554-New-Guy-Intro ). Meds by Dr. Caleb Calkins I've been compliant with (missed 3 HCG shots May 8-13 when I ran out of HCG, my mistake not Defy's) 100%. Prescribed test cyp 30mg EOD and 500iu HCG every 3.5days.

Total test went from 205 (range 264-916) at start to 731 and feeling pretty good at this level. However estradiol went from 26.2 (range 8.0-35) to 47 so guessing I'm headed to reduced dosage or a AI? Dr. Calkins mentioned Anastrozole .125mg depending on where I ended up in the follow-up bloodwork. My fault for talking him into trying EOD injections first. However still like their Slow & Low approach.

Free test went from 9.3 (range 6.6-18.1) to 25.0. SHGB went from 32.8 (range 19.3-76.4) to 29.8.

DHEA went from 132.6 LOW (range 48.9-344.2) to 413.9 HIGH. I was prescribed 25md/day. I've proactively reduced that to EOD. Am I jumping the gun on that or should I continue till the consult as Dr. Calkins mentioned ideal was 350?

Luckily my hematocrit number hasn't risen very much with it at 49.4 and prior 49.2. Whew. Precluded from donating blood due to a bone graft for dental implants. Wasn't looking forward to getting my Kaiser doctor to order a phlebotomy as she really isn't aboard with HRT as per Kaiser protocol.

Again thanks for any input as I start down the road of 'proper' HRT. Bob
 

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Systemlord

Member
As long as Free T is elevated estrogen can sometimes be an issue. There's nothing wrong with injecting more frequently as long as you feel good, estrogen could always have been higher if you were injecting larger doses less often. I think I can speak for others, if it isn't broke...

My first sign that estrogen is too high for me is if I get watery eyes easily during something that makes me happy or sad. The first 6 months of being on TRT I notice the watery eyes, but I felt pretty darn good, then after 6 months estrogen clearly became more of a beast to control and lowering the dosage did little to help estrogen even in the low 500's injecting EOD. I am insinuating that estrogen could become a problem later in the game for some.
 

lukdiver

New Member
Thanks. No issues yet as far as noticeable estrogen symptoms. Already went EOD and happy with that and not really looking forward to every-day. Been back-filling test syringes(27ga) and find it's nearly painless as far as puncture is concerned. Can't say the same for HCG and thinking about ordering 29g syringes as Vince recommended. Looking forward to consult with Defy. Bob
 

lukdiver

New Member
Yes on phlebotomy but I read on someone's post here that their doctor wouldn't honor a out-of-state script? I'll cover it during the consult and see if I run it by my Kaiser doctor. Dr. Calkins in initial consult commented that living at 1000'-elevation it might explain my initial 49.2 number? Overall I'm feeling pretty good and much better sleep. Been intermittent fasting (20/4) last 3 months and lost #20 which helped in multiple ways.
 

lukdiver

New Member
Consult went well, proactively me switching DHEA to EOD was what nurse Christie ordered. Going A.I. (anastrozole .125mg) 2x a week. I just can't see injecting T everyday at this time. Some symptoms of the the high estrogen but only one I've noticed is nocturnal wood less pronounced and nothing I feel as far as nipple sensitivity, etc? Given go-ahead for running 6-months and self-monitoring symptoms. Life is good.
 

Roguejim

New Member
Consult went well, proactively me switching DHEA to EOD was what nurse Christie ordered. Going A.I. (anastrozole .125mg) 2x a week. I just can't see injecting T everyday at this time. Some symptoms of the the high estrogen but only one I've noticed is nocturnal wood less pronounced and nothing I feel as far as nipple sensitivity, etc? Given go-ahead for running 6-months and self-monitoring symptoms. Life is good.

Your consultation was with nurse Christie? I wonder how that works when you have a consultation with someone who's not the Dr who wrote the original prescriptions? Did the nurse consult with Dr. Calkins prior to changing the meds/dosage? I guess I'm asking "who is in charge, the Dr, or the nurse?"
 

CoastWatcher

Moderator
Your consultation was with nurse Christie? I wonder how that works when you have a consultation with someone who's not the Dr who wrote the original prescriptions? Did the nurse consult with Dr. Calkins prior to changing the meds/dosage?
All changes are reviewed by Dr. Saya, Defy's medical director. In passing, it should be noted that Christie is an Advanced Registered Nurse Practitioner, fully licensed by the state of Florida to provide medical care. Patients who consult her are in good hands.

You have a great deal of anxiety about tele-medicine and raise questions about it regularly. I'm sure Defy would be happy to address your concerns, patient or not, if you called them. It's an emerging mode of practice. They've undoubtedly heard it all and can respond to you.
 
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Paco1973

Member
lukdiver,

I would consider lowering the dose before I'd consider adding another drug into the mix. Your free test is high, so you have some room to drop down a bit. I haven't had any E2 issues when mine was as high as 50, so I'm not so sure that the golden rule of 20 or so is all that accurate for everyone. If you feel good, run with it.
 
Id cut the dose and get your Free T closer to the lab range rather than add an AI even at this small dose. I would advise against adding another drug when a dose reduction is completely appropriate. Don't focus on TT...it's bound up and of no significance...dose based on the Free T and remember that's your trough and the LOW point in your treatment.
 

lukdiver

New Member
I'll drop a line to Defy but at this time I'm just going with A.I. 2x a week and see if I notice any improvement of small symptoms I've noticed. Yes I understand the 'concern' most of the guys here on Excel Male have on A.I.'s. Much agree with Coastwatchers assessment of Christie and found her knowledgeable. Dr. Caldwell was a month further out on appointments and I was stressing too much already waiting 2 weeks for LabCorp results to add another month. I'll plan better next consult for bloodwork and appt.
 
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