Joined Defy Medical-- Does this treatment protocol make sense?

[NEO]

At Nelson's suggestion I had my consultation with Dr Saya over the phone about a week ago. He went over my labwork. My total t came in at 343 on a range of 348-1197. I'm 35 y/o. I basically have all the classic symptoms of low t-- no libido, low energy, depression, no morning wood, increased body fat, ED, brain fog, etc.

The doc decided to start me off on HCG at 1 mL every 3 days for 30 days. In addition, I'm to take 0.25 mg of anastrazole every 3 days (12 pills). I'm also to take 30 mg DHEA every day for 45 days. Days 31-45 I'm to take 1 pill of chlomid (50 mg). The reason for this protocol is to determine if my hypogonadism is primary or secondary. If it is indeed primary, then at some point I will be placed on t cypionate as the HCG will be ineffective.

Does this sound like a sound treatment plan? I may very well want to have kids in a couple of years if I can get my health in order.

I just had my first injection of HCG a few days ago. How long does it usually take to feel a difference from the HCG?

I have a lot of fat around my belly. Can this inhibit the HCG from working? If so, should I inject in my upper glute?

That is all for now, thank you for any answers!
NEO

 

[Nelson Vergel]

Your total T is close to midrange, so I think your protocol is a good idea to see how your testicles respond.

HCG works pretty fast. No data on subcutaneous fat and its absorption is available. High subcutaneous fat content can increase aromatization and thus, estradiol.

What is your height and weight? The best way to increase testosterone is to lose weight.

 

[NEO]

Thanks, Nelson. I'm 5'8 172 pounds 26% bf. I sent you a link of my pictures when we did the phone consultation a couple weeks ago in December. It is hard to lose weight with no energy and skewed hormone levels. As you said, it is a catch-22. Would you advise replacing the zoloft with SAM-E?

-NEO

 

[Nelson Vergel]

I had good results with low dose SAMe but at higher recommended doses it can cause anxiety. I am not recommending anything that goes against doctor's orders, though.

https://www.excelmale.com/forum/thr...cts-the-Liver?highlight=S-Adenosyl+methionine

 

[Sterling]

I too joined Defy late last year but my protocol was quite different than yours considering I have the same symptoms and T levels. Mine was 415. Dr. Saya prescribed 100mg of test cyp., 350 units of Hcg and 1mg of Anastrazole all taken twice per week plus 40mgs of DHEA everyday. I had to stop because it accelerated my hair loss but our prescribed protocols are significantly different. Any ideas? Anyone?

 

[tmckenzie]

It makes sense to me given your age. I wish I had gone to defy first. Maybe I would have not had such a rough time. I am 35. The more I look the more young men I see with low t. I am wondering might it be possible to start a section for young men, say 25 to 40 that have low t. I have a feeling that it is caused by things other than age. And I think it may need to be treated differently than older men as well. I think endocrine disputing chemicals is to blame.

 

[Gene Devine]

I don't know why you needed an HCG mono-therapy to determine if you are Primary or Secondary as blood work tells that story.

Sure you got that right?

HCG can increase endogenous testosterone but it does not have a great success rate for getting serum levels into the optimal levels...only Testosterone can do that.

I'd like to see your entire blood work if you have it...sure others would as well.

Welcome to the forum Neo!

 

[NEO]

Sterling, it is probably due to age difference. I'm 35 y/o and this has been going on since I was in my late twenties.

Gene, that is what I was told by Dr Saya. This 45-day treatment period is diagnostic. It will help to determine if the issue is in my testicles or elsewhere. They are trying to jumpstart my testicles so they produce their own test without having to rely on exogenous test. If it doesn't work, then there is always test cyp injections.

I'm happy to share my bloodwork. I have yet to receive the latest results from Defy though. What is the easiest way to share it? Nelson has seen what I have thus far.

So far I've done 2 injections of HCG and don't feel anything but it is still early in the treatment. Keeping fingers crossed.

NEO

 

[Gene Devine]

HCG can act differently in each man and is dependent upon a number of variables like age and length of low androgen deficiency.

You will probably notice a better sense of well being and increase in libido as well soon.

HCG, and LH analog, does much more in the body than just stimulate endogenous testosterone...I love the stuff for many reasons...it's a great and very safe water based peptide.

 

[NEO]

I too joined Defy late last year but my protocol was quite different than yours considering I have the same symptoms and T levels. Mine was 415. Dr. Saya prescribed 100mg of test cyp., 350 units of Hcg and 1mg of Anastrazole all taken twice per week plus 40mgs of DHEA everyday. I had to stop because it accelerated my hair loss but our prescribed protocols are significantly different. Any ideas? Anyone?

How old are you? If you are in your 40s chances are doc is not too concerned about preserving your fertility. I think it is actually a relief to know that Dr Saya is not using a "one-size fits all" approach to treating his patients. Everybody is different and I don't know what your bloodwork was like.

Why not just cut back on the test cyp rather than stop treatment all together? I hear taking rogaine can help with the hair loss.

 

[NEO]

I don't know why you needed an HCG mono-therapy to determine if you are Primary or Secondary as blood work tells that story.

Sure you got that right?

HCG can increase endogenous testosterone but it does not have a great success rate for getting serum levels into the optimal levels...only Testosterone can do that.

I'd like to see your entire blood work if you have it...sure others would as well.

Welcome to the forum Neo!

What are serum levels? Also, I should be getting my labwork back today. What is the easiest way to share the values without having to retype them? I could scan it but I don't want to reveal my identity.

I administered my third injection of HCG today but still don't feel any difference. Is this normal? I wonder if the bodyfat around my waist is somehow inhibiting the HCG. Should I try injecting it into my upper glute?

NEO

 

[Gene Devine]

What are serum levels? Also, I should be getting my labwork back today. What is the easiest way to share the values without having to retype them? I could scan it but I don't want to reveal my identity.

I administered my third injection of HCG today but still don't feel any difference. Is this normal? I wonder if the bodyfat around my waist is somehow inhibiting the HCG. Should I try injecting it into my upper glute?

NEO

Serum level simply means the measurement of a particular component in your blood stream in our case it would be Testosterone.

If you can scan you labs, after blocking out your personal information, you can upload the file to your thread.

HCG should not be inhibited by body fat. It takes time for things to work so don't have to high of an expectation that you will feel anything immediate.

Usually a man notices a better sense of well being and increased libido first as HCG acts as a neuro-hormone.

 

[NEO]

Ok, here are my lab values. Please let me know what you think and whether my treatment plan is sound. Does anything strike you as alarming? One thing I find odd is that my estradiol levels were at 32 and 27 pg/mL respectively (reference range < 39 pg/mL) in the Quest Diagnostic Lab reports which were done a couple of month ago yet here Lab Corp has them at 19.4!! What gives?

I'm on my 4th injection of HCG tomorrow. I'm still not getting morning wood with consistency nor is my libido back.

By the way, here are some pics taken of me a couple of months ago.

-Would taking a higher dose of arimidex help me to lose some fat?

-Could taking testosterone help to get rid of the gyno by converting some of the fat in my chest to muscle?

Hopefully all of this information will give you some sense of what is going on with me. Thank you for taking the time to look all this over!

http://goodlookingloser.com/forums/index.php?topic=2764.msg26024#msg26024

I have the labwork from a few months ago ordered by a different test clinic if you would like to see it but here is the most recent.

Thanks,
NEO

 

[tmckenzie]

Well, that test is def low. Who knows is tha estrdiol is right. That does not look like the sensitive assay. Why mess around with hcg? I would see if I could find out why my test is low to begin with, then start trt is nothing can be done to bring it up. Based on your pics, just my observation, you are or have been estrogen dominate.

 

[Gene Devine]

Labs look good with the exception of Testosterone levels which clearly are low and presented with symptoms.

Would have liked to have seen SHBG and tmckenzie is correct, the estrogen lab should have been the Sensitive assay.

While 35 would be considered young for such low values the fact is TRT Doc's are seeing more and more younger guys with lower serum levels for many reasons.

Personally, I don't think HCG is going to get your levels up to anything close to optimal levels. HCG mono-therapies are rarely effective in raising serum levels and if it was effective we'd all be on it instead of Testosterone.

I think you will soon be put on a TRT protocol once the Defy medical staff reviews your next round of labs.

 

[NEO]

Would have liked to have seen SHBG and tmckenzie is correct, the estrogen lab should have been the Sensitive assay.

While 35 would be considered young for such low values the fact is TRT Doc's are seeing more and more younger guys with lower serum levels for many reasons.

SHBG = 19 (10-50 nmol/L) taken from a Quest Diagnostics Lab done last June.

Thanks, Gene! So I guess my estrogen is probably closer to upper 20s than upper teens.

~NEO

 

[Gene Devine]

The default E2 lab, designed for women, tends to over estimate a man's values...so you could be even lower believe it or not!

SHBG looks fine. You would be better injecting twice weekly when/if you start TRT. You don't want SHBG to go lower and one larger weekly shot can have that effect on SHBG levels.

 

[tmckenzie]

Gene, not to take away from this persons thread, as I imagine he would want to know as well. I have yet to find out how a low sgbh effects trt? Mine stays 16 or lower. Neos is 19 and you say he should not go any lower.

 

[Gene Devine]

SHBG finds its own levels in men and is not one to be overly concerned about.

Very low levels have neg sides like anxiety and the such but see a higher level of Free Testosterone.

Very elevated levels can see Free Testosterone levels being suppressed.

 

[tmckenzie]

Interesting. I would give up some free to get rid of benzos for anxiety. Thanks!