Dr. Chrisler gone, Defy booked, numbers off, now what?

[stlstudent]

I switched over to Defy Medical in June of this year and liked what I experienced. I was paired up with Dr. Chrisler (did I have a choice??) and he went over my test results which were pretty good already because I had been getting treatment from a local clinic (long story, they are closed). Dr. Chrisler made a few small adjustments and this was my protocol:

.5 ml of 200/mg Test-C twice weekly Sub Q
.25 AI on shot days
10 units of HCG every day Sub Q
1 grain of nature thyroid daily
A lot of fish oil (he was very concerned about hematocrit)

Did my blood work on my own a month later through discountedlabs.com and here are the main things

Total T: 877 Free T: 37.9 E2: 24 TSH: 4.29 T3: 3.4 T4: .8 Hematocrit: 51.3

Was feeling decent......but that last month or two I have not been doing too well. Very agitated and unhappy. Very fatigued and tired and overall just feeling blah... Called Defy and asked if I was due for bloodwork since I thought originally they said they would get it in 6 weeks but it is now 5 months. They sent me the script and I went in at the end of November and here is what came back (Quest Diagnostics)

Total T: 1342 Free T: 382 E2: 58 TSH: 2.20 T3: 3.9 T4: .8 Hematocrit: 56.5

Wow! My testosterone really shot up and I'm sure that is what caused the agitation and anger. I do not want to be that high if thats what i causes! Worried about Hematocrit jumping that much too! So I call Defy to see if they received my results and they had about a week ago. I asked if i could get an appointment with Dr. Chrisler to change my protocol to get me back in line and they advise me he is no longer with them. Even worse, no one else such as Dr. Saya is available untill end of December or beginning of January.

What do you think caused my numbers to jump so high?
Do you think those numbers are causing my overall terrible feeling?
Can I "self adjust" my meds until I can finally talk to Dr. Saya? Where would you start?

 

[johndoesmith]

I switched over to Defy Medical in June of this year and liked what I experienced. I was paired up with Dr. Chrisler (did I have a choice??) and he went over my test results which were pretty good already because I had been getting treatment from a local clinic (long story, they are closed). Dr. Chrisler made a few small adjustments and this was my protocol:

.5 ml of 200/mg Test-C twice weekly Sub Q
.25 AI on shot days
10 units of HCG every day Sub Q
1 grain of nature thyroid daily
A lot of fish oil (he was very concerned about hematocrit)

Did my blood work on my own a month later through discountedlabs.com and here are the main things

Total T: 877 Free T: 37.9 E2: 24 TSH: 4.29 T3: 3.4 T4: .8 Hematocrit: 51.3

Was feeling decent......but that last month or two I have not been doing too well. Very agitated and unhappy. Very fatigued and tired and overall just feeling blah... Called Defy and asked if I was due for bloodwork since I thought originally they said they would get it in 6 weeks but it is now 5 months. They sent me the script and I went in at the end of November and here is what came back (Quest Diagnostics)

Total T: 1342 Free T: 382 E2: 58 TSH: 2.20 T3: 3.9 T4: .8 Hematocrit: 56.5

Wow! My testosterone really shot up and I'm sure that is what caused the agitation and anger. I do not want to be that high if thats what i causes! Worried about Hematocrit jumping that much too! So I call Defy to see if they received my results and they had about a week ago. I asked if i could get an appointment with Dr. Chrisler to change my protocol to get me back in line and they advise me he is no longer with them. Even worse, no one else such as Dr. Saya is available untill end of December or beginning of January.

What do you think caused my numbers to jump so high?
Do you think those numbers are causing my overall terrible feeling?
Can I "self adjust" my meds until I can finally talk to Dr. Saya? Where would you start?

Okay, it'd be helpful if you uploaded the full results not just these few values.

Also, when were these tests taken relative to injection?

Testosterone doesn't cause anger or "roid rage", that's a myth, it's usually high E2 that causes that.

As to why your numbers jumped, I assume it's because you tested the first at trough and the second at peak.

Your HCT is dangerously high btw, I am not sure what you can do because most blood banks will not take you at that level, defy will have to write you a script for phlebotomy.

I also don't think end of december is that long for first appointment in normal cases, as 1 month is pretty typical, but for you, it seems much more urgent. I'd call them tomorrow and ask to speak to a PA or RN, I've done that and Melissa called me back within a few hours.

 

[thatoneguy]

I would recommend asking to speak with the PA or RN. My initial was also with Dr. Chrisler, but all my followup have been done without and they are all very knowledgeable and can get you on the right track.

 

[Jackie Treehorn]

I'd call them tomorrow and ask to speak to a PA or RN, I've done that and Melissa called me back within a few hours.

Concur.

Stlstudent, number one on your "to do" list is to get a script for a therapeutic phlebotomy, and get that HCT level down. Forward your labs to Defy, and talk to Nurse Jill, or PA Melissa. This needs to be done NOW!

A full set of labs drawn at trough would be helpful for any of us to comment about adjustments to your protocol, but you should be providing these to Defy anyways, and getting their professional opinion.

 

[Vince Carter]

When my HCT creeps up like right now, I feel tired and a little "winded", I'm donating this Saturday. In the mean time, Nurse Jill is who I consult with there, she's A++ in my book. I too would surmise that you're two tests aren't both in a trough and would question which E2 you took. Posting numbers isn't too helpful, scanned lab tests are always preferred.

 

[Dr Justin Saya MD]

I switched over to Defy Medical in June of this year and liked what I experienced. I was paired up with Dr. Chrisler (did I have a choice??) and he went over my test results which were pretty good already because I had been getting treatment from a local clinic (long story, they are closed). Dr. Chrisler made a few small adjustments and this was my protocol:

.5 ml of 200/mg Test-C twice weekly Sub Q
.25 AI on shot days
10 units of HCG every day Sub Q
1 grain of nature thyroid daily
A lot of fish oil (he was very concerned about hematocrit)

Did my blood work on my own a month later through discountedlabs.com and here are the main things

Total T: 877 Free T: 37.9 E2: 24 TSH: 4.29 T3: 3.4 T4: .8 Hematocrit: 51.3

Was feeling decent......but that last month or two I have not been doing too well. Very agitated and unhappy. Very fatigued and tired and overall just feeling blah... Called Defy and asked if I was due for bloodwork since I thought originally they said they would get it in 6 weeks but it is now 5 months. They sent me the script and I went in at the end of November and here is what came back (Quest Diagnostics)

Total T: 1342 Free T: 382 E2: 58 TSH: 2.20 T3: 3.9 T4: .8 Hematocrit: 56.5

Wow! My testosterone really shot up and I'm sure that is what caused the agitation and anger. I do not want to be that high if thats what i causes! Worried about Hematocrit jumping that much too! So I call Defy to see if they received my results and they had about a week ago. I asked if i could get an appointment with Dr. Chrisler to change my protocol to get me back in line and they advise me he is no longer with them. Even worse, no one else such as Dr. Saya is available untill end of December or beginning of January.

What do you think caused my numbers to jump so high?
Do you think those numbers are causing my overall terrible feeling?
Can I "self adjust" my meds until I can finally talk to Dr. Saya? Where would you start?

Stlstudent - my PA, Melissa, will be contacting you today via PM to obtain your info and to discuss. Also, staff will be arranging a therapeutic phlebotomy RX for you. Stand by.

 

[Dr Justin Saya MD]

Stlstudent - my PA notified me that she sent you a PM this morning. Respond or call the office at your earliest convenience.

 

[stlstudent]

Thanks, I received her message and responded that I am currently away with students on a convention until late Friday night. I can try to sneak away for a phone call but for the current moment, email is best.

 

[stlstudent]

trying to figure out how to get the whole lab up. That second test should have been in trough. I had it drawn on a Wednesday late morning and I inject on Monday mornings and Thursday evenings. I donate blood every time I'm allowed and have been for almost a year. My HCT was creeping down around the 48 range until this last one. As far as the E2, I took whatever was written on the script that Defy sent me (unless Quest screwed it up).

 

[stlstudent]

Okay, it'd be helpful if you uploaded the full results not just these few values.

Also, when were these tests taken relative to injection?

Testosterone doesn't cause anger or "roid rage", that's a myth, it's usually high E2 that causes that.

As to why your numbers jumped, I assume it's because you tested the first at trough and the second at peak.

Your HCT is dangerously high btw, I am not sure what you can do because most blood banks will not take you at that level, defy will have to write you a script for phlebotomy.

I also don't think end of december is that long for first appointment in normal cases, as 1 month is pretty typical, but for you, it seems much more urgent. I'd call them tomorrow and ask to speak to a PA or RN, I've done that and Melissa called me back within a few hours.

Working on getting the entire tests results up.

Test was taken on a Weds late morning, injection was early Monday morning.

Interesting about anger being a myth because I've had high E2 before and it was more of the sad feeling. This is different, this is quick fuse, angry, etc... it literally scared me. The highest I've ever been before this is 960

I donate every chance I'm allowed with Red Cross. When I started I was at 52 percent and then was down to 49 until this one. I cannot seem to find anywhere that says Red Cross wont take blood with high HCT. Matter of fact, they never test for it so how would they know? They do a finger stick for hemoglobin though, looking for too low.

This wouldn't be my first appointment, it would be my second. The first was with Dr. Chriser as my initial consult.

 

[CoastWatcher]

trying to figure out how to get the whole lab up. That second test should have been in trough. I had it drawn on a Wednesday late morning and I inject on Monday mornings and Thursday evenings. I donate blood every time I'm allowed and have been for almost a year. My HCT was creeping down around the 48 range until this last one. As far as the E2, I took whatever was written on the script that Defy sent me (unless Quest screwed it up).

If you inject on Monday morning your trough is Monday morning, prior to the injection. If you inject on Thursday evening, your trough is Thursday afternoon, prior to your injection. If you injected on Monday, and tested on a Wednesday, you did NOT capture a trough reading.

 

[stlstudent]

If you inject on Monday morning your trough is Monday morning, prior to the injection. If you inject on Thursday evening, your trough is Thursday afternoon, prior to your injection. If you injected on Monday, and tested on a Wednesday, you did NOT capture a trough reading.

agreed, but the point I guess I was trying to make was that I was not also at a peak. Either way around it, I've never been at the 1300 mark and my E2 never stays that high

 

[johndoesmith]

Working on getting the entire tests results up.

Test was taken on a Weds late morning, injection was early Monday morning.

Interesting about anger being a myth because I've had high E2 before and it was more of the sad feeling. This is different, this is quick fuse, angry, etc... it literally scared me. The highest I've ever been before this is 960

I donate every chance I'm allowed with Red Cross. When I started I was at 52 percent and then was down to 49 until this one. I cannot seem to find anywhere that says Red Cross wont take blood with high HCT. Matter of fact, they never test for it so how would they know? They do a finger stick for hemoglobin though, looking for too low.

This wouldn't be my first appointment, it would be my second. The first was with Dr. Chriser as my initial consult.

You inject E3.5D right? So monday morning and thursday night, meaning you're at 48-54 hours post injection and trough would be 84 hours post injection. There can be variations in those 36ish hours, I had 1150 48 hours post and 914 72 hours post injection. I do E3D. This is just anecdotal.

AFAIK "roid rage" in and of itself isn't caused directly by high testosterone, it's from high E2. I don't think your sudden anger is caused by the TRT though, and it seems like within the past month, something major has changed in your life.

I say that because, a 4 point increase in HCT is pretty large for one month and with the change in test and E2, it's just so sudden. Did ANYTHING in your life change? A new supplement, medication OTC or Rx, new anything? The anger too is an odd element as well that's new it seems.

Regarding the red cross, you're right they don't directly check HCT, but with high HCT generally comes high HGB(unless you're dehydrated then HCT is artificially inflated) which is what they test. At 18.7 I'm pretty sure they won't accept you but I'm not positive.

Honestly, this is fairly complex and I do believe Dr saya or his staff will figure it out. Something had to have changed, whether you are aware of it or not, so I'd try to think about anything that you've done differently in the past month.

Hope you figure out what's wrong.

Did you get a prescription refill or anything?

 

[CSI007]

ALT is way high. Do you have liver issues?

 

[stlstudent]

ALT is way high. Do you have liver issues?

my primary physician has been keeping an eye on this since the beginning of time and it really is unchanged. Only thing I've done for it is the metabolic detox from defy for two months but it did not change much (maybe dropped 4 pts). Primary does not seem to concerned about it yet but does keep an eye on it??

 

[stlstudent]

Wow, just got off the phone with Melissa from Defy. She called at 7pm eastern time just to touch base with me, that is amazing 'customer service'. I believe we have a plan of action and will go from here, thank you for all your responses and Melissa, I hope Santa Clause brings you something extra special this Christmas for the kindness and caring you exhibit!

 

[Vince Carter]

Okay, it'd be helpful if you uploaded the full results not just these few values.

Also, when were these tests taken relative to injection?

Testosterone doesn't cause anger or "roid rage", that's a myth, it's usually high E2 that causes that.

As to why your numbers jumped, I assume it's because you tested the first at trough and the second at peak.

Your HCT is dangerously high btw, I am not sure what you can do because most blood banks will not take you at that level, defy will have to write you a script for phlebotomy.

I also don't think end of december is that long for first appointment in normal cases, as 1 month is pretty typical, but for you, it seems much more urgent. I'd call them tomorrow and ask to speak to a PA or RN, I've done that and Melissa called me back within a few hours.

That's just not true. No blood bank screens for HCT. There is a cutoff for HGB which can vary but my blood bank (not Red Cross) its like 19 or 20.

 

[johndoesmith]

That's just not true. No blood bank screens for HCT. There is a cutoff for HGB which can vary but my blood bank (not Red Cross) its like 19 or 20.

I may have implied that, but later followed up with "but with high HCT generally comes high HGB(unless you're dehydrated then HCT is artificially inflated) which is what they test".

Thanks.

 

[steve-wv]

I may have implied that, but later followed up with "but with high HCT generally comes high HGB(unless you're dehydrated then HCT is artificially inflated) which is what they test".

Thanks.

I have been dealing with the PA Melissa as well. Nothing but positive to say . Very knowledgeable and has responded to several questions after hours. No complaints with Defy here.