Have T Prescription, Unsure if I should fill it

[wjl]

Hello everyone,

I am 29 years old and my most recent Total T was 378 ng/dL with free T of 7.0 pg/mL (another test with a different company in same month/time of day showed 502 total and 9.63 free)

My symptoms have been low energy, lack of libido, lack of enthusiasm for life/depression, anxiety, and erectile dysfunction (but I think the ED is psychological because it’s only a problem when I have a girl with me. Works fine when I’m by myself, and I still get morning wood).

I recently had a consultation with Defy Medical and got prescribed 150mg Test C/week (over 3 injections), 350 iu HCG 3x a week, Anastrozole 0.125mg 3x a week, and DHEA 25mg by mouth every night.

I’ve been having some serious second thoughts about this based on the following reasons:

#1: I work for the military in Korea, so while I can receive the medications at my military shipping address, the sensitive estradiol blood test is not available in Korea. This concerns me because I know balancing E2 is one of the most important aspects of TRT.

#2: 150mg/week sounds like a high starting dose and goes against the adage of “start low and start slow” that I’ve heard others like Dr. John Crisler advise. The reason for it I was told is that my SHBG is high (46.38 nmol/L) so I need more T to have an effect.

#3: I’m not sure it’s a good idea to start on an anti-E off the bat. I’ve always read it’s something to use only when you see symptoms of high E.

I am currently leaning toward not starting TRT due to the reasons above, however I’m not fully decided either way. I am hoping to hear what other people think as well. Thank you for your help.



My historical blood test results through the military have been the following:


July 2018: 378 ng/dl; 7.0 pg/ml free
May 2017: 448 ng/dl; 6.6 pg/ml free
December 2016: 376.6 ng/dl
June 2016: 370 ng/dl; 6.0 pg/ml free

I also had a blood test done by a private clinic in Korea in July 2018, with the following results:

Total T: 502 ng/dl
Free T: 9.63 pg/ml (range 5.4 to 40)
Estradiol (E2) (not the sensitive test): 20.78 pg/ml
Total Estrogen: 119.88 pg/ml
DHEA-Sulfate: 205.34 ug/dl
SHBG: 46.38 nmol/L (range 18.30 to 54.10)
PSA: 0.60 ng/ml
TSH: 2.090 IU/ml
FSH: 2.69 mIU/ml
LH: 4.65 mIU/ml
Free T3: 3.22 pg/ml
Free T4: 1.57 ng/dl
Prolactin: 14.76 ng/ml
HDL: 61.6 mg/dl (H)
LDL: 63 mg/dl
Triglycerides: 42 mg/ml
BUN: 24.1 mg/dl (H)
Insulin: 3.39 mIU/L
Vitamin D: 46.18 ng/ml
Cortisol: 16.52 ug/dl
Albumin: 4.92 g/dl
Progesterone: 0.29 ng/ml
IGF-BP3: 2052.85 ng/ml
IGF-1: 143.96 ng/ml (L)
Hemoglobin: 14.5 g/dl
Hematocrit: 45.6 g/dl
RBC: 4.73
WBC: 5.68

 

[Vince Carter]

I dont think TRT would be questionable but I agree that your protocol as prescribed is a suspect mainly because of your SHBG. I don' tthink you need more than twice per week, the dose I'd cut to 120mg (60 x 2), no AI and no DHEA. Start there. No HCG either, Id prefer to get started on Cyp alone and see how you do.

You gonna have any problems with the meds coming thru customs?

 

[wjl]

The reason I thought 3x a week is ok was to reduce T conversion to estrogen. I'm deathly afraid of getting bitch tits.

I'm hesitant to not use HCG because I want to maintain my ball volume and fertility.

Customs won't be an issue because it's treated just like a US postal address despite being overseas. The bigger issue is lack of access to the sensitive E2 test in Korea so it's hard to get an accurate read on my E2.

Why no DHEA?

 

[Weasel]

The reason I thought 3x a week is ok was to reduce T conversion to estrogen. I'm deathly afraid of getting bitch tits.

I'm hesitant to not use HCG because I want to maintain my ball volume and fertility.

Customs won't be an issue because it's treated just like a US postal address despite being overseas. The bigger issue is lack of access to the sensitive E2 test in Korea so it's hard to get an accurate read on my E2.

Why no DHEA?

DHEA is known to convert to e2. Its good to get a baseline without it. Then if/when you start DHEA and see a rise in e2, you'll know the cause.

 

[Vince Carter]

Gynocomastia is exceedingly RARE.

 

[Vince Carter]

Im just flashing back to my year in Korea in 1991 everything had a customs declaration on it that wasn't a first class envelope, just brainstorming if you have that problem, or not.

 

[JMP]

I have been with Defy for 16 months on the exact same protocol as you were prescribed. My starting t and e levels were also very similar to yours. I chose not to use the Anstrozole for the first year but am using the same dose (.125/2-3x per wk) now for the last 4 months or so when my E sensitive climbed to 40 and I was getting night sweats and getting emotional. It solved the problem and I have felt great on that protocol the whole 16 months (except for the night sweats). Not getting blood work for another 2 months so, not sure where my e level is but I feel great so hopefully it is close to perfect. I agree with Vince that you could get by with 2 injections per week if you wanted with your SHBG level. I don't think bitch tits are a worry. I believe that you will get other symptoms (night sweats/moodiness) way before it gets to that. I use night sweats as my guage on whether to take Anastrozole 2 or 3x each week. Was taking it 2x until last week when my wife asked if I had my period as I was being a negative dick. Funny because the night sweats came back that night as well. With that said TRT is a personal decision and I wish you the best.

 

[JMP]

Oh and you might want to try 5-10mg of cialis daily for the ED. It works wonders and can eliminate the mental block of worrying about getting it up. I also recommend l-cittruline. Genes NO stack has even more possibilities if those two don't do it for you.

 

[mooseman109]

DHEA made my E2 climb high. I dropped it as I could not tell any different in how I felt. I also would avoid anatrazole. I actually dropped hug, but I have had vasectomy so not really import for me.
On a second note, my best bud is in AF, he is a boom operator and he was told straight up if he went on Test it would ground him for many months while waiting on the proper authorization.

 

[Vince Carter]

DHEA made my E2 climb high. I dropped it as I could not tell any different in how I felt. I also would avoid anatrazole. I actually dropped hug, but I have had vasectomy so not really import for me.
On a second note, my best bud is in AF, he is a boom operator and he was told straight up if he went on Test it would ground him for many months while waiting on the proper authorization.

That's assuming you divulge anything which is debatable should you or shouldn't you. last I knew a urinalysis would go hot but I don't know where the threshold there is, what the trigger would be, assuming if you were under the lab range then you'd get a green light.