Defy dosage. Need opinions

ermin

New Member
Hey guys. Had my consultation with Defy the other day. Starting me at 220mg weekly. I’m going to go with 2 days per week. .55ml. Thinking about going with shallow IM.

My numbers are

- 558 ng/dl

- free - 45.2 pg/ml

- SHGB - 70. High.

- estradiol 20 pg

- LH - 2.9

- DHEA-S - 131

I’d like to know your thoughts on this and what you guys would do. I’ve been working out my whole life. I’m 47. 6ft 1 200lbs. I work out 4 to 5 days per week. Count my calories, etc. the whole nine. Would love to hear your thoughts. I know 220 is high but my SHGB is high as well. Thanks in advance. Should be arriving by next week. Can’t wait to get it started. Your opinions would be greatly appreciated
 
Hey guys. Had my consultation with Defy the other day. Starting me at 220mg weekly. I’m going to go with 2 days per week. .55ml. Thinking about going with shallow IM.

My numbers are

- 558 ng/dl

- free - 45.2 pg/ml

- SHGB - 70. High.

- estradiol 20 pg

- LH - 2.9

- DHEA-S - 131

I’d like to know your thoughts on this and what you guys would do. I’ve been working out my whole life. I’m 47. 6ft 1 200lbs. I work out 4 to 5 days per week. Count my calories, etc. the whole nine. Would love to hear your thoughts. I know 220 is high but my SHGB is high as well. Thanks in advance. Should be arriving by next week. Can’t wait to get it started. Your opinions would be greatly appreciated

NUTTY!

This is extreme overkill especially off the hop!

The doctor treating you is out to lunch!

Most men on T therapy are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.

The MAJORITY of men can easily hit a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.

Yes as I have stated numerous times on here over the years there will always be this outliers who may need the high-end dose 200 mg T/week but its far from common as in RARE.

Such dose would have the MAJORITY of men overmedicated.

Keep in mind there are also some men who can achieve stellar levels injecting <100 mg T/week especially when split into more frequent injections.

The standard starting dose by those in the know across the board is 100 mg T/week or the more sensible move would be 50 mg T split twice-weekly.

Always best to start low and go slow on a T only protocol so we can see how your body reacts to testosterone and where said protocol (dose T/injection frequency) has your trough TT and more importantly FT, estradiol and SHBG let alone critical blood markers RBCs, hemoglobin and hematocrit.

There will always be time to increase the dose or throw in hCG if need be.

Trust me when I tell you going up is much easier than having to come down.

The last thing you want to do here is jack up your FT off the hop and even then chances are slim that you would even need a whopping 220 let alone 200 mg T/week.




I know 220 is high but my SHGB is high as well.

Yes high doses can have a stronger impact on driving down SHBG but even if one's SHBG never budged all you would need to do is increase your TT to drive up your FT.

Men with higher SHBG will need to hit a higher TT to achieve a healthy, high or absurdly high FT.

Just because one has high SHBG it does not justify one needing let alone starting on a high dose of T.

This is a myth that needs to be put to rest!

Again the majority of men can easily achieve a healthy/high FT injecting 100-150 mg T/week especially when split into more frequent injections and this includes men with high SHBG!

Bad move here diving in head first with that whopping weekly dose of T!

It will take 4-6 weeks to reach steady-state (TC/TE) and you will get your blood work done to see where said protocol (dose T/injection frequency) has your trough TT, FT, estradiol, SHBG and RBCs, hemoglobin and hematocrit.

Keep in mind when first starting T therapy or in cases where one may eventually need to tweak their protocol and increase the weekly dose of T hematocrit will start rising within the 1st month and the biggest increase will be seen at the 3-6 month mark and even then levels can take upwards of 9-12 months to fully stabilize for some.

So where your hematocrit sits at 6 weeks and 3 months in means jack s**t when looking at the bigger picture here.

This is just a snapshot to make sure your are hitting a healthy FT and moving in the right direction.

If by chance your trough FT is too low which is highly doubtful in most cases then you can easily bump up your dose by 20-25 mg/week and retest in 6 weeks.
 
My thoughts:


Start off with half that and try 110/week. Let your body settle in and start building up an emergency supply by only taking half of what is prescribed. Doing this over the course of months or years will allow you to build up a stockpile which can help you get through shortages or other supply chain disruptions.

That’s just how I would approach it though. Which path you decide to take is completely up to you.
 
Hey guys. Had my consultation with Defy the other day. Starting me at 220mg weekly. I’m going to go with 2 days per week. .55ml. Thinking about going with shallow IM.

My numbers are

- 558 ng/dl

- free - 45.2 pg/ml

- SHGB - 70. High.

- estradiol 20 pg

- LH - 2.9

- DHEA-S - 131

I’d like to know your thoughts on this and what you guys would do. I’ve been working out my whole life. I’m 47. 6ft 1 200lbs. I work out 4 to 5 days per week. Count my calories, etc. the whole nine. Would love to hear your thoughts. I know 220 is high but my SHGB is high as well. Thanks in advance. Should be arriving by next week. Can’t wait to get it started. Your opinions would be greatly appreciated
Are you using any HCG?
 
Hey guys. Had my consultation with Defy the other day. Starting me at 220mg weekly. I’m going to go with 2 days per week. .55ml. Thinking about going with shallow IM.

My numbers are

- 558 ng/dl

- free - 45.2 pg/ml

- SHGB - 70. High.

- estradiol 20 pg

- LH - 2.9

- DHEA-S - 131

I’d like to know your thoughts on this and what you guys would do. I’ve been working out my whole life. I’m 47. 6ft 1 200lbs. I work out 4 to 5 days per week. Count my calories, etc. the whole nine. Would love to hear your thoughts. I know 220 is high but my SHGB is high as well. Thanks in advance. Should be arriving by next week. Can’t wait to get it started. Your opinions would be greatly appreciated

Seeing as you are being treated through Defy they are out to lunch when it comes to testing the most critical fraction here free testosterone as they use/rely on the known to be inaccurate direct immunoassay (CLIA/RIA) which no one should be using!

In order to know where your FT true sits you would need to have it tested using the most accurate assay which is the gold standard Equilibrium Dialysis especially in cases of altered SHBG.

Just pay out of pocket and test your FT using the most accurate assay.

Your cheapest and most sensible option would be through Nelson's discounted labs.

This is the panel you want when testing TT (LC/MS-MS) and more importantly FT (ED)!

$48

It will be done through Quest and just ignore the top-end of the reference range which is 15.5 ng/dL as it is not standardized and most of the ED assays used by some of the other clinical diagnostic labs top-end for FT is 21-28 ng/dL.

As I have stated numerous times on the forum the MAJORITY of men will do well with a trough FT 15-25 ng/dL depending on the injection frequency.

If you do not have access to the gold standard ED assay which is highly doubtful unless you live outside of the US then you would need to use/rely on the next best testing method the go-to calculated linear law-of-mass action Vermeulen (cFTV) which will give a good approximation mind you it tends to overestimate slightly.

Just to put this in perspective!

FT <5 ng/dL would be considerd low.

FT 5-9 ng/dL would be considered the grey zone where some men may experience symptoms of low-T.

FT 10-15 ng/dL would be healthy.

FT 20-25 ng/dL would be high-end/high.

The majority of men will do well with a trough FT 15-25 ng/dL depending on the injection frequency.

If we use the go to calculate linear law-of-mass action Vermeulen (cFTV) which is available online for free and plug in your descent TT 558 ng/dL,high SHBG 70 nmol/L and Albumin 4.3 g/dL (default) then your cFTV 7.03 ng/dL would be close to the bottom-end as in subpar but not flagged as low.


1775313271862.webp


Your cFTV would fall in what would be called the grey zone 5-9 ng/dL where some men may experience symptoms of low-T.

Even then it is a dismal FT especially for any young healthy male as most would be hitting a peak cFTV 13-15 ng/dL and this is a short-lived daily peak to boot.

Now getting back to your high SHBG supposedly justifying starting you on let alone needing a whopping dose of T!

Again even if your SHBG never budged on therapy which is highly doubtful you would just need to hit a higher TT to drive up your FT.

As I stated previously the MAJORITY of men will do well with a trough FT 15-25 ng/dL depending on the injection frequency.

If we take your high SHBG 70 nmol/L then you would need to hit a TT 1038-1512 ng/dL to hit a healthy/high FT 15-25 ng/dL.

1775313759156.webp

1775313776166.webp



Again even when using a much lower weekly dose then 200-220 mg T/week your SHBG will be pushed down so you will be able to get away with hitting a lower TT to achieve a healthy/high FT!
 
You could reduce your dose of testosterone and add HCG.

Not could more like needs!

Clear as day here it is a ridiculous starting dose.

You should know this by now.

Throwing in hCG off the hop is. a bad move here too as he has no idea how his body is going to react to T and where said protocol (dose T/injection frequency) will have his trough TT and more importantly FT, estradiol and. SHBG.

Even then it will be hard teasing out any issue he may run into if he throws in the hCG as it will also drive up T and more importantly estradiol.

Waiting 6 weeks until blood levels have stabilize so he can have blood work done is no big deal here as throwing in hCG off the hop is not the deal breaker.

Start low and go slow on a T only protocol!

There will always be time to increase the dose of T or throw in hCG if need be!

This is a given.
 

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