Defy Patient, Can't Receive HCG via Post

[BigFilly]

Hello to all!

Just wanted to make a quick introduction and say how much I appreciate this forum. I recently reached out to Defy Medical for all the usual low T symptoms and will soon start injections in the coming weeks. A few of my numbers are listed below:

Total - 568
Free - 8
Estradiol- 20
SHBG - 51
LH - 3

I was surprised given my toal T number being what it is that I was a candidate. The PA explained that my free Test was low relative to my total T due to SHBG being high. I'm sure I'm missing some of the reasons for treatment, but that can be discussed later.

I do have a question about HCG though. They prescribed it, but my state doesn't allow it to be shipped via mail. I really don't need to remain firtle as I have 3 kids and a vasectomy, lol! But, I don't want to experience testicular atrophy or reduced seminal fluid (both of which the doc said would happen if I didn't use HCG). Any ideas?

Anyway, look forward to learning from you guys!

 

[CoastWatcher]

Welcome to Excelmale. Obviously, you weren't aware of this regulatory issue when you consulted Defy - did they raise the topic with you? I recall previous threads in the topic of interstate shipment of certain medications. What advice, if any, did they offer?

 

[BigFilly]

You're right, I wasn't aware of that until my initial consultation and they informed me that regulations prevented shipment to the state I live in. They suggested to have it shipped to a friend or relative in a state where's it is possible to do so, and then to have them ship it to me. Sounded like a lot of additional steps...and quite honestly, don't have anyone I'd feel comfortable asking to do that for me. Is there an alternative to hcg that will keep the boys hanging and fluid there?

 

[BigFilly]

They also suggested to go to the compounding pharmacy and pick it up from them. The closest one is a 5 hour drive so that's really not a feasible option...

 

[ERO]

You can get your own here: http://www.safemeds4all.com/search_product.php?searchtxt=HCG&searchtype=whole&x=0&y=0

 

[Dr Justin Saya MD]

Good 'ole Louisiana...lobby your medical board for them to get out of the Stone Ages and stop disciplining physicians for the legitimate use of HCG as adjunct to TRT!

 

[BigFilly]

Lol, yea we're in the stone ages with a few things still! Dr. Saya, is there any alternative to HCG to reduce the chance of testicular atrophy with long term testosterone use? I've seen some info on the Web where guys will, for lack of a better term, pulse dose clomid to keep testosterone producing in their testes as well as keep seminal fluids up. Any truth to this?

 

[Dr Justin Saya MD]

Lol, yea we're in the stone ages with a few things still! Dr. Saya, is there any alternative to HCG to reduce the chance of testicular atrophy with long term testosterone use? I've seen some info on the Web where guys will, for lack of a better term, pulse dose clomid to keep testosterone producing in their testes as well as keep seminal fluids up. Any truth to this?

Anecdotally I've seen a few guys report that Clomid *seemed* to have worked in that capacity, however I've also seen, in virtually every case, where the LH/FSH were still completely suppressed...so the physiology of how the Clomid could work in that capacity is intriguing. Plus, it introduces some of the complexities of Clomid treatment (zuclomiphene isomer in particular) which certainly complicates the TRT regimen in other ways. Best option is an alternative source of HCG, or one of the other workarounds for Louisiana. My heart hurts for Louisiana patients, but I personally know of a few physicians (two of which are now my patients) whom have been hounded by the medical board on the HCG topic. There are physicians in Louisiana who prescribe it, and pharmacies who ship it, but it is at their own peril (moreso for the physicians with regard to the medical board).

 

[Dr Justin Saya MD]

BigFilly - We can give low dose Clomid a try for you as a substitute if you like, but keep in mind the aforementioned facts above.

If you'd like, forward this thread to one of my staff at the office for inclusion in your chart. We can run Clomid 12.5mg three times weekly and include LH/FSH on follow-up labs (be sure to mention this to staff). You pay attention to testicular size and we'll pay attention to LH/FSH. Have your follow-up scheduled with ME and we'll review thoroughly at that time. Discontinue Clomid if any visual side effects (blurry vision, floaters, etc) occur - unlikely at such low doses but monitor nonetheless.

 

[BigFilly]

BigFilly - We can give low dose Clomid a try for you as a substitute if you like, but keep in mind the aforementioned facts above.

If you'd like, forward this thread to one of my staff at the office for inclusion in your chart. We can run Clomid 12.5mg three times weekly and include LH/FSH on follow-up labs (be sure to mention this to staff). You pay attention to testicular size and we'll pay attention to LH/FSH. Have your follow-up scheduled with ME and we'll review thoroughly at that time. Discontinue Clomid if any visual side effects (blurry vision, floaters, etc) occur - unlikely at such low doses but monitor nonetheless.

That's great, thanks Dr. Saya!

 

[Dr Justin Saya MD]

That's great, thanks Dr. Saya!

No worries, given your predicament we'll see if you may turn into one of those anecdotal success stories.