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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
New Defy Medical Patient - Please Critique Protocol
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<blockquote data-quote="DrSilkWater" data-source="post: 72402" data-attributes="member: 15813"><p>Hello ExcelMale Community,</p><p></p><p>I am new the to community, but have been lurking for a while. I finally took the plunge to address my low T, got my labs done, contacted Defy, had my consultation with Dr. Calkins (super nice & informative guy.</p><p></p><p></p><p><span style="font-size: 15px"><u><strong>CBC With Differential/Platelet</strong></u></span></p><p>WBC 5.2 x10E3/uL 3.4 - 10.8 01</p><p>RBC 4.60 x10E6/uL 4.14 - 5.80 01</p><p>Hemoglobin 14.2 g/dL 12.6 - 17.7 01</p><p>Hematocrit 41.6 % 37.5 - 51.0 01</p><p>MCV 90 fL 79 - 97 01</p><p>MCH 30.9 pg 26.6 - 33.0 01</p><p>MCHC 34.1 g/dL 31.5 - 35.7 01</p><p>RDW 13.8 % 12.3 - 15.4 01</p><p>Platelets 214 x10E3/uL 150 - 379 01</p><p>Neutrophils 55 % 01</p><p>Lymphs 31 % 01</p><p>Monocytes 10 % 01</p><p>Eos 3 % 01</p><p>Basos 1 % 01</p><p>Neutrophils (Absolute) 2.9 x10E3/uL 1.4 - 7.0 01</p><p>Lymphs (Absolute) 1.6 x10E3/uL 0.7 - 3.1 01</p><p>Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9 01</p><p>Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01</p><p>Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01</p><p>Immature Granulocytes 0 % 01</p><p>Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01</p><p>Comp. Metabolic Panel (14)</p><p>Glucose, Serum 88 mg/dL 65 - 99 01</p><p>BUN 14 mg/dL 6 - 20 01</p><p>Creatinine, Serum 0.84 mg/dL 0.76 - 1.27 01</p><p>eGFR If NonAfricn Am 115 mL/min/1.73 >59</p><p>eGFR If Africn Am 133 mL/min/1.73 >59</p><p>BUN/Creatinine Ratio 17 9 - 20</p><p>Sodium, Serum 139 mmol/L 134 - 144 01</p><p>Potassium, Serum 4.1 mmol/L 3.5 - 5.2 01</p><p>Chloride, Serum 100 mmol/L 96 - 106 01</p><p>Carbon Dioxide, Total 22 mmol/L 18 - 29 01</p><p>Calcium, Serum 9.5 mg/dL 8.7 - 10.2 01</p><p>Protein, Total, Serum 7.2 g/dL 6.0 - 8.5 01</p><p>Albumin, Serum 4.5 g/dL 3.5 - 5.5 01</p><p>Globulin, Total 2.7 g/dL 1.5 - 4.5</p><p>A/G Ratio 1.7 1.2 - 2.2</p><p>Bilirubin, Total 0.7 mg/dL 0.0 - 1.2 01</p><p>Alkaline Phosphatase, S 78 IU/L 39 - 117 01</p><p>AST (SGOT) 16 IU/L 0 - 40 01</p><p>ALT (SGPT) 18 IU/L 0 - 44 01</p><p></p><p><span style="font-size: 15px"><u><strong>Lipid Panel</strong></u></span></p><p>Cholesterol, Total 248 High mg/dL 100 - 199 01</p><p>Triglycerides 46 mg/dL 0 - 149 01</p><p>HDL Cholesterol 55 mg/dL >39 01</p><p>VLDL Cholesterol Cal 9 mg/dL 5 - 40</p><p>LDL Cholesterol Calc 184 High mg/dL 0 - 99</p><p></p><p></p><p></p><p>25-Hydroxyvitamin D LCMS D2+D3</p><p>25-Hydroxy, Vitamin D 30 ng/mL 02</p><p>Reference Range:</p><p>All Ages: Target levels 30 - 100</p><p>25-Hydroxy, Vitamin D-2 <1.0 ng/mL 02</p><p>25-Hydroxy, Vitamin D-3 30 ng/mL 02</p><p></p><p></p><p>IGF-1</p><p>IGF-1(BL) 112 ng/mL 02</p><p></p><p>Hemoglobin A1c</p><p>Hemoglobin A1c 5.4 % 4.8 - 5.6 01</p><p>Please Note: 01</p><p>Pre-diabetes: 5.7 - 6.4</p><p>Diabetes: >6.4</p><p>Glycemic control for adults with diabetes: <7.0</p><p></p><p></p><p>Thyroid Peroxidase (TPO) Ab 9 IU/mL 0 - 34 01</p><p>Triiodothyronine,Free,Serum 2.7 pg/mL 2.0 - 4.4 01</p><p></p><p>T4,Free(Direct) 1.23 ng/dL 0.82 - 1.77 01</p><p>TSH 0.795 uIU/mL 0.450 - 4.500 01</p><p></p><p></p><p>Testosterone,Free and Total</p><p>Testosterone, Serum 341 Low ng/dL 348 - 1197 01</p><p>Free Testosterone(Direct) 6.8 Low pg/mL 8.7 - 25.1 01</p><p></p><p>DHEA-Sulfate 306.8 ug/dL 138.5 - 475.2 01</p><p>Luteinizing Hormone(LH), S</p><p>LH 2.0 mIU/mL 1.7 - 8.6 01</p><p>Prolactin 8.2 ng/mL 4.0 - 15.2 01</p><p>Estradiol, Sensitive 19.9 pg/mL 8.0 - 35.0 03</p><p>Sex Horm Binding Glob, Serum 31.5 nmol/L 16.5 - 55.9 01</p><p></p><p></p><p></p><p>Prostate-Specific Ag, Serum</p><p>Prostate Specific Ag, Serum 0.4 ng/mL 0.0 - 4.0 01</p><p></p><p>IGF-1</p><p>Insulin-Like Growth Factor I 132 ng/mL 88 - 246 03</p><p></p><p></p><p>C-Reactive Protein, Cardiac 0.59 mg/L 0.00 - 3.00 01</p><p></p><p></p><p></p><p>IGF-BP3 2789 ug/L 2610 - 5977 03</p><p></p><p></p><p></p><p></p><p>Insulin 4.8 uIU/mL 2.6 - 24.9 01</p><p>Ferritin, Serum 130 ng/mL 30 - 400 01</p><p><u><strong></strong></u></p><p><u><strong>PROTOCOL:</strong></u></p><p><u><strong></strong></u></p><p><u><strong></strong></u>Testosterone Cypionate 200 mg/ml – 0.35 ml intramuscular/subcutaneous, twice a week. (25G, 5/8” needle/ (1cc syringe Luer Lock only)</p><p></p><p>HCG 400iu subcutaneous, twice a week. (to reverse/prevent testicular atrophy)</p><p></p><p>Anastrozole 0.25mg twice a week. (h/o elevated E2, titrate on follow-up)</p><p></p><p>Vitamin D3 5000iu daily</p><p></p><p>Fish oil 3-4g every day for HDL support</p><p></p><p>Nature Thyroid 1/2 grain every morning, 30 min before food.</p><p></p><p><u><strong>QUESTIONS:</strong></u></p><p><u><strong></strong></u></p><p><u><strong></strong></u>1) I've read conflicting info on HCG dosing. Should I be taking it 1 day before my twice weekly test injections as Dr. Crisler recommends or same day?</p><p></p><p>2) Dr. Calkins suspects I have hypothyroidism, however, is it smarter to separate the thyroid hormones from the TRT treatment so I can isolate any sides vs taking concurrently and not knowing what is causing what?</p><p></p><p>3) dosing schedule mentions AI immediately, but from what I've gathered, is it smarter to take 2-4 weeks down the road? It seems that flatlining E2 tends to be a major cause of disruption for dialing in and feeling great on TRT</p><p></p><p>4) Any real studies on Sub Q vs IM Test absorption rates as well as results via each delivery method?</p><p></p><p>5) Why only a luer lock? (says on dosing instructions above)</p><p></p><p>6) needle recommendation anyone, e.g. optimal gauge, length, CC size.</p><p></p><p>7) I carry alot of fat on my gut and chest, no gyno, no lumps, just my fat storage pattern, should this be taken into consideration if i go the Sub Q route? </p><p></p><p>8) Also, should I be concerned about gyno and E2 since I already hold fat there and am predisposed.</p><p></p><p>9) I want to continue losing fat as I have been before I hit a wall, anyone recommend any dietary protocols or "best practices" for achieving fat loss and greek god ripped (lol) when on TRT?</p><p></p><p>Disclaimer: This is no way a reflection of Dr. Calkins service or knowledge, he was excellent and I felt truly in good hands vs PCP whom for over a decade told me my 300ish test was ok and there was no issue with my thyroid. Howver to be honest, I am scared because I've never injected myself with anything so want to find out as much info as I can. I think it's only smart to do as much diligence as possible on a lifetime protocol. So tired of being average and restricted due to my hormones. I am 34 years old and ready to live my life to the max.</p><p></p><p>Thanks!</p><p></p><p>PS - I apologize if I deviate from any thread posting protocols, I've never posted before. Thanks</p></blockquote><p></p>
[QUOTE="DrSilkWater, post: 72402, member: 15813"] Hello ExcelMale Community, I am new the to community, but have been lurking for a while. I finally took the plunge to address my low T, got my labs done, contacted Defy, had my consultation with Dr. Calkins (super nice & informative guy. [SIZE=4][U][B]CBC With Differential/Platelet[/B][/U][/SIZE] WBC 5.2 x10E3/uL 3.4 - 10.8 01 RBC 4.60 x10E6/uL 4.14 - 5.80 01 Hemoglobin 14.2 g/dL 12.6 - 17.7 01 Hematocrit 41.6 % 37.5 - 51.0 01 MCV 90 fL 79 - 97 01 MCH 30.9 pg 26.6 - 33.0 01 MCHC 34.1 g/dL 31.5 - 35.7 01 RDW 13.8 % 12.3 - 15.4 01 Platelets 214 x10E3/uL 150 - 379 01 Neutrophils 55 % 01 Lymphs 31 % 01 Monocytes 10 % 01 Eos 3 % 01 Basos 1 % 01 Neutrophils (Absolute) 2.9 x10E3/uL 1.4 - 7.0 01 Lymphs (Absolute) 1.6 x10E3/uL 0.7 - 3.1 01 Monocytes(Absolute) 0.5 x10E3/uL 0.1 - 0.9 01 Eos (Absolute) 0.2 x10E3/uL 0.0 - 0.4 01 Baso (Absolute) 0.0 x10E3/uL 0.0 - 0.2 01 Immature Granulocytes 0 % 01 Immature Grans (Abs) 0.0 x10E3/uL 0.0 - 0.1 01 Comp. Metabolic Panel (14) Glucose, Serum 88 mg/dL 65 - 99 01 BUN 14 mg/dL 6 - 20 01 Creatinine, Serum 0.84 mg/dL 0.76 - 1.27 01 eGFR If NonAfricn Am 115 mL/min/1.73 >59 eGFR If Africn Am 133 mL/min/1.73 >59 BUN/Creatinine Ratio 17 9 - 20 Sodium, Serum 139 mmol/L 134 - 144 01 Potassium, Serum 4.1 mmol/L 3.5 - 5.2 01 Chloride, Serum 100 mmol/L 96 - 106 01 Carbon Dioxide, Total 22 mmol/L 18 - 29 01 Calcium, Serum 9.5 mg/dL 8.7 - 10.2 01 Protein, Total, Serum 7.2 g/dL 6.0 - 8.5 01 Albumin, Serum 4.5 g/dL 3.5 - 5.5 01 Globulin, Total 2.7 g/dL 1.5 - 4.5 A/G Ratio 1.7 1.2 - 2.2 Bilirubin, Total 0.7 mg/dL 0.0 - 1.2 01 Alkaline Phosphatase, S 78 IU/L 39 - 117 01 AST (SGOT) 16 IU/L 0 - 40 01 ALT (SGPT) 18 IU/L 0 - 44 01 [SIZE=4][U][B]Lipid Panel[/B][/U][/SIZE] Cholesterol, Total 248 High mg/dL 100 - 199 01 Triglycerides 46 mg/dL 0 - 149 01 HDL Cholesterol 55 mg/dL >39 01 VLDL Cholesterol Cal 9 mg/dL 5 - 40 LDL Cholesterol Calc 184 High mg/dL 0 - 99 25-Hydroxyvitamin D LCMS D2+D3 25-Hydroxy, Vitamin D 30 ng/mL 02 Reference Range: All Ages: Target levels 30 - 100 25-Hydroxy, Vitamin D-2 <1.0 ng/mL 02 25-Hydroxy, Vitamin D-3 30 ng/mL 02 IGF-1 IGF-1(BL) 112 ng/mL 02 Hemoglobin A1c Hemoglobin A1c 5.4 % 4.8 - 5.6 01 Please Note: 01 Pre-diabetes: 5.7 - 6.4 Diabetes: >6.4 Glycemic control for adults with diabetes: <7.0 Thyroid Peroxidase (TPO) Ab 9 IU/mL 0 - 34 01 Triiodothyronine,Free,Serum 2.7 pg/mL 2.0 - 4.4 01 T4,Free(Direct) 1.23 ng/dL 0.82 - 1.77 01 TSH 0.795 uIU/mL 0.450 - 4.500 01 Testosterone,Free and Total Testosterone, Serum 341 Low ng/dL 348 - 1197 01 Free Testosterone(Direct) 6.8 Low pg/mL 8.7 - 25.1 01 DHEA-Sulfate 306.8 ug/dL 138.5 - 475.2 01 Luteinizing Hormone(LH), S LH 2.0 mIU/mL 1.7 - 8.6 01 Prolactin 8.2 ng/mL 4.0 - 15.2 01 Estradiol, Sensitive 19.9 pg/mL 8.0 - 35.0 03 Sex Horm Binding Glob, Serum 31.5 nmol/L 16.5 - 55.9 01 Prostate-Specific Ag, Serum Prostate Specific Ag, Serum 0.4 ng/mL 0.0 - 4.0 01 IGF-1 Insulin-Like Growth Factor I 132 ng/mL 88 - 246 03 C-Reactive Protein, Cardiac 0.59 mg/L 0.00 - 3.00 01 IGF-BP3 2789 ug/L 2610 - 5977 03 Insulin 4.8 uIU/mL 2.6 - 24.9 01 Ferritin, Serum 130 ng/mL 30 - 400 01 [U][B] PROTOCOL: [/B][/U]Testosterone Cypionate 200 mg/ml – 0.35 ml intramuscular/subcutaneous, twice a week. (25G, 5/8” needle/ (1cc syringe Luer Lock only) HCG 400iu subcutaneous, twice a week. (to reverse/prevent testicular atrophy) Anastrozole 0.25mg twice a week. (h/o elevated E2, titrate on follow-up) Vitamin D3 5000iu daily Fish oil 3-4g every day for HDL support Nature Thyroid 1/2 grain every morning, 30 min before food. [U][B]QUESTIONS: [/B][/U]1) I've read conflicting info on HCG dosing. Should I be taking it 1 day before my twice weekly test injections as Dr. Crisler recommends or same day? 2) Dr. Calkins suspects I have hypothyroidism, however, is it smarter to separate the thyroid hormones from the TRT treatment so I can isolate any sides vs taking concurrently and not knowing what is causing what? 3) dosing schedule mentions AI immediately, but from what I've gathered, is it smarter to take 2-4 weeks down the road? It seems that flatlining E2 tends to be a major cause of disruption for dialing in and feeling great on TRT 4) Any real studies on Sub Q vs IM Test absorption rates as well as results via each delivery method? 5) Why only a luer lock? (says on dosing instructions above) 6) needle recommendation anyone, e.g. optimal gauge, length, CC size. 7) I carry alot of fat on my gut and chest, no gyno, no lumps, just my fat storage pattern, should this be taken into consideration if i go the Sub Q route? 8) Also, should I be concerned about gyno and E2 since I already hold fat there and am predisposed. 9) I want to continue losing fat as I have been before I hit a wall, anyone recommend any dietary protocols or "best practices" for achieving fat loss and greek god ripped (lol) when on TRT? Disclaimer: This is no way a reflection of Dr. Calkins service or knowledge, he was excellent and I felt truly in good hands vs PCP whom for over a decade told me my 300ish test was ok and there was no issue with my thyroid. Howver to be honest, I am scared because I've never injected myself with anything so want to find out as much info as I can. I think it's only smart to do as much diligence as possible on a lifetime protocol. So tired of being average and restricted due to my hormones. I am 34 years old and ready to live my life to the max. Thanks! PS - I apologize if I deviate from any thread posting protocols, I've never posted before. Thanks [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
New Defy Medical Patient - Please Critique Protocol
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