Good questions to Prepare for First Defy Medical Consult?

[Supraman]

I have an appt monday, june 12 with Dr Calkins. I am excited to finally get my hormones under control and possibly feel even half way like the testimonials people report about there improvements. For backround, I am 26, bloodwork showed total T at 202, sensitive E at 19. Around 5 years ago I tested at 405 total T so Ive never been a big testosterone producer. I have also had injuries such as a fractured skull and when very young I suffered an injury to my left nut, which the Dr. didnt know what was, but called it circulation being cut off to my nut due to being very active in sports. It felt like someone kicked me in my nut for 3-4 weeks straight. Couldnt walk normal at all. So since I don't really believe I have anything worth restarting, I would assume the Dr. would prescribe Testosterone. But he's the Dr. and I will surely do whatever he says so who knows. That is also part of why I am posting this, I am wondering what to expect so I don't feel blind going into this consultation.

So I was wondering if there were any questions you guys had after you finished your consult but failed to ask during your initial consult. I am piling some questions in a word document, along with some of their supplements I want to try out, like the Lipo C fat loss injection and magnesium, to make sure I am well prepared. I am sure there will be more questions that I will have as I go along, but wanted to make sure I wasn't missing any that most don't think to ask their first time with the Dr.
Thank you all for any replies.

 

[ratbag]

I too had fractured my skull in a car crash when I was 7 years old. I was diagnosed at age 50 as being hypopituitary because of that crash and all my hormones were very very low. It was suggested I start HRT. I didn't realize I had been living in depression all those years until they got all my hormones working properly... it's no easy task to get right and what's important for you is to have all your hormones evaluated by someone who specializes in that field... like Dr Calkins and not some hospital MD who claims to understand everything.

 

[Supraman]

I too had fractured my skull in a car crash when I was 7 years old. I was diagnosed at age 50 as being hypopituitary because of that crash and all my hormones were very very low. It was suggested I start HRT. I didn't realize I had been living in depression all those years until they got all my hormones working properly... it's no easy task to get right and what's important for you is to have all your hormones evaluated by someone who specializes in that field... like Dr Calkins and not some hospital MD who claims to understand everything.

Ya I am looking forward to finally getting a very good grip on this and get a protocol of what to do from the doc. Im very anxious to start with Defy.

 

[Vince]

For me TRT is pretty simple. Testosterone cypionate, HCG, no AI and a health lifestyle.

 

[Supraman]

Simple is nice to hear.

 

[CoastWatcher]

Do you have your pre-consultation lab results? If you post them, we may be able to see areas that suggest questions/discussion for you and Dr. Calkins.

 

[Supraman]

Do you have your pre-consultation lab results? If you post them, we may be able to see areas that suggest questions/discussion for you and Dr. Calkins.

i took photos of my labs here so i could upload. I was slightly off on remembering my e level. It was slightly lower actually at 17 it shows.

the hct has been taken care of as of now I believe. Did a follow up test after giving blood.

 

[CoastWatcher]

It would appear the incorrect estradiol test was run, but it is certainly low by any standard of measure. Be sure, in the future, that the sensitive, LC, MS/MS, lab assay is the one preformed.

Were these labs drawn when you were in a fasting state? The lipid and glucose reports certainly merit some discussion if you'd not eaten when the blood was drawn.

Were other thyroid tests run, in addition to the TSH? You're showing a reasonable TSH, but that's not the entire thyroid picture by any means.

I would certainly raise the question of your hematocrit and hemoglobin. It's a fairly common issue, the elevated report, for men on TRT. I would want to know how often he intends to monitor your CBC, and ask abiut iron and ferritin as well if frequent blood donations are in your future.

You don't believe that a restart is a likely path you'll follow, but what about fertility and children in your future? Have you had a sperm count done? Is banking sperm an option? You are young.

 

[Supraman]

are you certain that the sensitive E test was not the one performed? If so that would be a big mistake by the lab im using to perform my bloodwork tests, because I know the sensitive estrogen was written on the script.
Ya i am guessing I am going to need more bloodwork also because I am holding a ton of water weight and always have for the last 6 or so years.

 

[Supraman]

It would appear the incorrect estradiol test was run, but it is certainly low by any standard of measure. Be sure, in the future, that the sensitive, LC, MS/MS, lab assay is the one preformed.

Were these labs drawn when you were in a fasting state? The lipid and glucose reports certainly merit some discussion if you'd not eaten when the blood was drawn.

Were other thyroid tests run, in addition to the TSH? You're showing a reasonable TSH, but that's not the entire thyroid picture by any means.

I would certainly raise the question of your hematocrit and hemoglobin. It's a fairly common issue, the elevated report, for men on TRT. I would want to know how often he intends to monitor your CBC, and ask abiut iron and ferritin as well if frequent blood donations are in your future.

You don't believe that a restart is a likely path you'll follow, but what about fertility and children in your future? Have you had a sperm count done? Is banking sperm an option? You are young.

as far as fertility goes, I am not sure if I will decide to have children, so I would like to have that option if I end up wanting kids.

 

[Dr Justin Saya MD]

Just keep a list of ANY questions you have as a portion of your consult with Dr Calkins will be dedicated specifically to answering your questions.

Your lab did run the non-sensitive E2 assay (if you look at the notation below the result stating the LC-MS (sensitive assay) as an alternative).

 

[CoastWatcher]

Just keep a list of ANY questions you have as a portion of your consult with Dr Calkins will be dedicated specifically to answering your questions.

Your lab did run the non-sensitive E2 assay (if you look at the notation below the result stating the LC-MS (sensitive assay) as an alternative).

I'm sure that, despite running the incorrect test, Dr. Calkins will be able to sort through the highly relevant question of how your estradiol level impacts your overall protocol. Nonetheless, your lab failed you.

 

[Supraman]

Thank you for the reply Dr. Saya and coastwatcher. As to the lab error, I will probably change labs now. I had someone I know able to do my blood work for free, but if not done correctly thats no help.