I wonder if Defy Medical would be a better service to use instead of PrimeBody. Would you recommend I just add the SHBG test?
Getting first blood test since starting TRT...Do I need to add anything to the test?
- Thread starter Belmundo
- Start date
I wonder if Defy Medical would be a better service to use instead of PrimeBody. Would you recommend I just add the SHBG test?
CoastWatcher
Moderator
I would add the SHBG. No one else can decide who you should consult in regard to your medical care. Both Prime Body and Defy are sponsors of this site and members here are patients of both - and are pleased with their care. You have to look at the total picture and make your decision.
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Thank you for all your feedback. I'll speak with them tomorrow and then see how things go after the doctor reviews my blood work. If I don't like what I'm hearing, I'll reach out to Defy and see what they would recommend. I'll post updates and the labs as soon as I have them.
Dr Justin Saya MD
Moderator
Yes lumps that are palpable are a COMPLETELY different story as opposed to just simple nipple sensitivity. Get the sensitive estradiol test ASAP.
Thank you, Dr. Saya. My last Test Cyp injection was Saturday (1/7) and my last HCG injection was this morning. I was going to wait until Tuesday which is my next injection for both and I wanted to have a trough reading. Based on what I'm currently going through, would you recommend I get the blood work done tomorrow or wait until Tuesday morning before my injection?
Dr Justin Saya MD
Moderator
I've had a handful of patients recently transfer care from PrimeBody that were, quite frankly, receiving subpar care. I've heard secondhand of success stories as well, but I'm sure it's a challenge sustaining consistency across many different locations/providers. Different model, different challenges.
Dr Justin Saya MD
Moderator
If you have palpable lumps I would draw them sooner than later.
In your experience, will anastrozole reduce/remove these lumps once I start taking it if it turns out my E2 is too high? Also, do you know if there are NY/NJ doctors under Defy's network?
Dr Justin Saya MD
Moderator
Anastrozole can work if you catch it early enough (hence the suggestion to check levels ASAP). A course of Tamoxifen (or another SERM) may be needed temporarily if it appears early gynecomastia is setting up shop.
We are not a "network" per se. We have a centralized location (Tampa, FL) with a physical location/office where I practice. Treatment for non-local patients is done remotely. The office can clarify further if needed.
Thank you for your responses. I wasn't able to get blood work done until 1/10 and this was a trough reading.
Since I couldn't wait for the results I began taking the AI. On 1/11 I took .5mg of anastrozole, 1/13 took another .5mg, 1/14 took .75mg, 1/16 .5mg. I only have enough to take me to Sunday 1/22 with .5mg EOD protocol.
I just got my labs back today which took longer than last time because of the new tests I added. Again, this was a trough reading. As you can see, my estradiol sensitive is 30.1 pg/mL out of 8.0 - 35.0 so definitely on the HIGH side which explains the symptoms I've been experiencing besides the lumps which are now pretty damn solid. I'm going to reach out to the doctor and see if he can prescribe a SERM to help me reverse this. This really sucks because 2 weeks ago I was feeling really good (mood, libido, erections, etc) and as soon as I felt the nipple sensitivity I should've taken the anastrozole to control the estrogen. I'm pretty sensitive to it as this happened several years ago when I was an idiot and took Anavar and then self medicated with Letro.
Any insight as to why LDL would be high? I eat pretty healthy and work out. Vitamin D is high because I've been supplementing it so I'll probably cut that dosage down as I thought I was lacking in it. My SHBG seems low too, right? I have no idea what that means and what implications that has on my TRT protocol.
Based on my labs, is there anything you would recommend or anything I should mention to my doctor? I don't know if the anastrozole is helping to bring my estradiol levels down so I'll try and go 2 weeks with taking it and then just get a sensitive test only the week of 1/30. If I take a SERM with it or just by itself, will this floor my E2?
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CoastWatcher
Moderator
In all honesty, your estradiol, via the sensitive test, is hardly high, and with the dose of Anastrozole you've been taking it's probably been hammered at this point. Still, if you can feel palpable tissue in the breast area, and with your history, and the anxiety you feel you are going to do this, but it's still a significant dose. Low estradiol can make you miserable - I say that not to chide you but to remind you not to be surprised if you feel the effects of low e2. Your lower SHBG, though many fellows here have values in the teens, means you are likely to do better with smaller, more frequent doses of testosterone as low SHBG patients clear testosterone quickly.
It it is unfortunate that you didn't have these run prior to the start of therapy, but you now know where you stand.
Damn well this sucks. Once again, my self medicating has probably screwed me over. I know what low E2 is like (it's awful and so is low test) as I started out low 5.0 (Roche) out of 7.6 - 42.6. So I guess I'll stop taking the anastrozole as I don't think I took it soon enough to reverse the lumps. Will my E2 levels come back if they are in fact hammered? I noticed my libido and erections diminishing when I started to feel the formation of the lumps so whatever my E2 levels were at that time and now is high for me but I just don't know how the hell I'm ever going to get this dialed in. If I was taking .25mg of anastrozole 1x a week like originally prescribed would that have been too much? Is .25mg 1x every 2 weeks better? I'll speak to my doctor but now I'm just frustrated by this whole thing.
My current protocol is 100mg Test Cyp a week. I've been doing 50mg 2x week. Is 25mg 4x a week better?
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Well I give up now...
This is from the Prime Body doctor:
"Hi Belmundo, your estradiol level is perfect, I have never seen anyone with lumps below 70. If you feel lumps, I would stop all therapy until you can be examined by your primary are physician or general surgeon. No other SERM is necessary. Let me know how you proceed."
It's perfect, yet the symptoms state otherwise. I don't have insurance so I don't know how much an out of pocket visit is gonna cost me with a doctor to check my lady lumps. This reallyyyyyyy sucks. Not sure what to do here.
CoastWatcher
Moderator
Don't make further changes to your protocol at this point. Inject your HCG as prescribed, take the testosterone every 3.5 days, that is a sound protocol to follow. Are you sure you have tangible, palpable tissue in your breast area? I only raise this because your sensitive estradiol was in what is typically thought of as an excellent place. If you do, indeed, have lumps developing you probably should see a doctor who can examine that area and offer some guideance. I don't know how else your mind will be at peace.
What at about your care in the future? Is Prime Body who you wish to stay with?
What at about your care in the future? Is Prime Body who you wish to stay with?
I know there are glands in that area that can mimic signs of lumps like if they get swollen, right? but it feels like there is definitely something behind the nipples like little peas. I think the anastrozole has minimized the size only slightly because on 1/10 both sides were feeling bigger/wider in size. There has also been some discoloration (whitening) around the areola and the HCG has definitely caused some water retention/bloating in that area as well as the gut and face a little bit but the anastrozole has brought some of that down.
What kind of doctor would be best to see to check this out? An endo - do they do sonograms? If I get 100% confirmation, I'd feel better because then I'll know what the hell's going on and what my options are.
I definitely don't want to stop the TRT because for that short period of time, I felt great and I know I can get back to that if I can figure out how to manage my levels. I was going to PM Dr. Saya and have him come back to the thread and look things over and if I have to paypal, venmo, or give him my CC info for his time, I will do so. I like Prime Body for the shipping of the meds convenience and the prices for their blood tests are REALLY cheap. $21 out of pocket for sensitive estradiol so I can get this done every 2 weeks to check on my level if needed or every week. However, if I'm going to get actual sound advice and knowledge about what's going on with me, then I would definitely consider switching and especially if their prices make sense. Or if I can continue to with Prime and just work something out with Dr. Saya as a consultant, that would be good too. However, I will say, the responses I've gotten from Prime don't give me a whole lot of confidence to be honest.
CoastWatcher
Moderator
I took my test and hcg this morning and shortly after I feel the lumps diminish a little, does this mean anything?
I'll try and get in touch with Defy this week and start looking up doctors who are familiar with gyno. Do I discontinue the anastrozole or just cut it down to .25mg 1x a week? Or should I get a sensitive E test done this week and see where my levels are? It's funny, Dr. Saya recommends that I might need Tamoxifen to reverse the lumps but my Prime Body Dr. wants me to discontinue the TRT. I'm just confused and lost right now as to what to do exactly.
I'll try and get in touch with Defy this week and start looking up doctors who are familiar with gyno. Do I discontinue the anastrozole or just cut it down to .25mg 1x a week? Or should I get a sensitive E test done this week and see where my levels are? It's funny, Dr. Saya recommends that I might need Tamoxifen to reverse the lumps but my Prime Body Dr. wants me to discontinue the TRT. I'm just confused and lost right now as to what to do exactly.
CoastWatcher
Moderator
Getting in touch with Defy is as easy as picking up the phone. Call them and begin to out your mind at ease. Dr. Saya did NOT wrote that YOU needed tamoxifen- he isn't your doctor and hasn't examined you. He wrote that it was reasonable therapy for men with diagnosd gynocomastia who had failed to reverse it with Anastrozole. That was a general statement, not specific to your case. The doctor managing your case has seen you make several changes to your protocol, develop high anxiety, and begin discussing further changes. He undoubtedly wonders if TRT is something that makes sense for you.
Imwould call Defy. I would find a surgeon and have him/her examine you. I would make no changes to your protocol. I would test if it puts your mind at ease.
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