New TRT Protocol from Defy, Please Critique

[Rube99]

Hey all,

Just joined the site. I’m 50 years old and was diagnosed with low T like 5 years ago. Currently, 5’8” and 215 pounds. I’m pretty muscular since I work out a bunch (lift, cycle, and run). But it seems no matter how much I work out and diet, I can’t lose my belly fat (or get rid of fatigue).

I was on Clomid for several years trying to maintain fertility for IVF. I have a new baby daughter and 4 embryos to transfer later, so I no longer need my fertility. Plus, got low libido (just desire, no physical issues) on the Clomid apparently. So my urologist put me on testosterone cyp shots. His protocol was 200 mg every 14 days. After doing some research, this is a bad way to do things. So I ended up going to Defy Medical since they are only like 15 minutes from my office.

My labs are below. Be advised, I was on TRT for about 3 weeks after going off of the Clomid and the labs are 7 days after my last 200 mg IM injection. Also, my PSA was slightly elevated on prior labs and I wanted to err on the side of caution since I have a baby daughter now, so I had a prostate biopsy about a month ago, which was negative.

Defy has me on the below protocol which includes the TRT stuff and added T3 since my reverse T3 was high. Any thoughts or criticisms? Thanks in advance!

• T Cyp 200 mg/ml – inject 0.40 ml IM/SQ twice weekly 27G, 5/8” needle/ 29G, 1/2" needle (1cc syringe Luer only)
• HCG inject 400 iu(40 units) SQ twice weekly to reverse/prevent testicular atrophy
• Anastrozole 0.125 mg by mouth twice weekly as needed per E2 symptoms (reviewed with Pt.)
• DHEA 25 mg one by mouth every night
• Fish Oil 3grams daily for HDL support
• milk thistle 500mg by mouth daily
• Vit D 5000IU by mouth daily
• Cytomel 5mcg One by mouth every morning for one week, then 10mcg by mouth every morning for one week, then 15mcg by mouth every morning,then Stop titration if any hyperthyroid symptoms occur. Take first thing in am, on empty stomach, at least 30 minutes before breakfast

 

[Vince]

Your Labs with pretty good and your estrogen is not too high, hopefully you won't need your Anastrozole. I'm sure they could be a lot of improvement in your diet, especially with your lipid panel.

 

[Vince Carter]

After 90 days let's see where you're at, these labs aren't worth anything anymore. Otherwise follow your Dr's orders. This pick it apart when you haven't even started it isn't the best way to get things moving.

 

[Rube99]

After 90 days let's see where you're at, these labs aren't worth anything anymore. Otherwise follow your Dr's orders. This pick it apart when you haven't even started it isn't the best way to get things moving.

True. The labs are bit convoluted since I'm coming off the Clomid and in the middle of a 14-day injection interval from my prior doctor. Been hearing some criticisms of going on Anastrozole right away which I'm mostly concerned about.

 

[Rube99]

Your Labs with pretty good and your estrogen is not too high, hopefully you won't need your Anastrozole. I'm sure they could be a lot of improvement in your diet, especially with your lipid panel.

Yeah, the lipid panel doesn't look great given that heart disease runs in my family (although I think that's mostly due to family members who smoked). Since my Defy appointment, been religiously taking the fish oil that was reccomended. And I don't think my diet is that bad, but I can do better I'm sure.

 

[fifty]

I used to take 10g+ of fish oil per day back when I was competing. I think it’s funny they’ll prescribe 1000iu hcg 200mg of test (for example) then 3g fish oil. That’s like prescribing a handful of almonds after each injection of tren.

 

[Loki]

Yeah, the lipid panel doesn't look great given that heart disease runs in my family (although I think that's mostly due to family members who smoked). Since my Defy appointment, been religiously taking the fish oil that was reccomended. And I don't think my diet is that bad, but I can do better I'm sure.

That is an extremely low does AI, it wouldn't concern me. I take a similar amount. Last week I was feeling burning at my nipples and general symptoms of high E. I took a full MG of Anastrozole and literally had rock hard erections for 2-3 days. I mean like when I was 18, absolutely amazing. I have no idea what was up. The only thing it could be is maybe my estrogen had creeped up but man I'd love to be like that all the time.... I'd probably never leave the bathroom in pure amazement of myself ….

Also Lipids are a lot genetics. My good cholesterol has never been higher than the 20's and I have tried everything. If anybody has good advice on getting the good up let me know! My family history is beyond frightening but so far I'm doing good. BP is good but cholesterol is similar to yours.....

 

[Vince Carter]

They prescribe the AI because in the TRT mainstream it's kind of an expected thing to have, IMO. Though .125mg isn't really enough to hurt some one thru a low E situation. Probably universal advice you got and what we'd tell you is to not take it, learn what elevated E symptoms are compromised of then consider it. There will be a lot in flux in 90days to your first follow up and set of labs will be very hard to say about E.

 

[Systemlord]

Been hearing some criticisms of going on Anastrozole right away which I'm mostly concerned about.

AI's have their place and are needed sometimes in the beginning of treatment until you get a handle on things and improved diet and exercise regularly. I personally can't take even 1/4 of a 0.050 anastrozole as I just hyper-respond to it.

I recovered pretty quickly after knocking down my estrogen to 12 pg/mL, within days of stopping it recovery was fast.

 

[S1W]

Only thing I would change is ditch the luer locks (if that is what they gave you) and get some 28g or 29g insulin syringes.

I guess I don't understand why people don't just start with T only first, dial that in, then add the other stuff (HCG + AI) if necessary...but hey I'm not the doctor.

 

[fifty]

27g I don’t know how y’all use 28g+. For me it’s like trying to inject into a rock regarding plunger force required.

Insulin syringes have far less waste which is why they’re preferred. Low dead space luer lock wastes .05ml per injection in the tip.

 

[Rube99]

Only thing I would change is ditch the luer locks (if that is what they gave you) and get some 28g or 29g insulin syringes.

I guess I don't understand why people don't just start with T only first, dial that in, then add the other stuff (HCG + AI) if necessary...but hey I'm not the doctor.

Thanks for the advice. I'll look into it since they did send me the luer locks. My prior doctor presribed me 23 gauge 1 inch for IM injections. They hurt a little afterwards. But smaller diameter (and SC) does sound better.

 

[Rube99]

So, I am about 4 weeks in with my Defy protocol (after 3 weeks of that 200 mg every 14 days crap). Libido is better. But everything else doesn't feel much different or great. Gained a couple of pounds, mood is towards the depressive side as of late, no extra energy, physical recovery from exercise is the same, gym performance same. Testicle ache is mostly gone, but still there and bothers me some when I cycle, which is super annoying since I ride for an hour or more on Saturdays.

Is it just too early to feel anything? I know I am probably not dialed in. But shouldn't things be changing a bit for the better? Should I contact Defy maybe? Next blood test isn't till the end of Aug.

Thanks for reading

 

[lowTengineer]

So, I am about 4 weeks in with my Defy protocol (after 3 weeks of that 200 mg every 14 days crap). Libido is better. But everything else doesn't feel much different or great. Gained a couple of pounds, mood is towards the depressive side as of late, no extra energy, physical recovery from exercise is the same, gym performance same. Testicle ache is mostly gone, but still there and bothers me some when I cycle, which is super annoying since I ride for an hour or more on Saturdays.

Is it just too early to feel anything? I know I am probably not dialed in. But shouldn't things be changing a bit for the better? Should I contact Defy maybe? Next blood test isn't till the end of Aug.

Thanks for reading

I try to wait 8 weeks after a protocol change before I try to decide if I like the changes or not. In the beginning of TRT for me when I first started making adjustments I would feel really crappy for 4-6 or so weeks. Now that I'm only making small adjustments I think I stopped getting the crappy rundown feeling, but I like to give it time to decide if I improved or not.

You can schedule an appointment at any time with Defy. They are a business and will accept your money. I would wait until at least 6 weeks just to make sure your hormones have settled down.

 

[S1W]

FWIW, whenever I make a protocol change I notice that the period around weeks 3 and 4 are when I feel the worst. For some reason erectile function, mood etc are great the first week after a change, week 2 seems "normal", then weeks 3 and 4 I feel off and start doubting my protocol change (even though I've been through this a few times and know better) then I usually start to feel some improvement into weeks 5 and 6.

So basically, you're in the worst spot now and only half way there.

The ball aches will eventually subside.

 

[antelopers]

FWIW, whenever I make a protocol change I notice that the period around weeks 3 and 4 are when I feel the worst. For some reason erectile function, mood etc are great the first week after a change, week 2 seems "normal", then weeks 3 and 4 I feel off and start doubting my protocol change (even though I've been through this a few times and know better) then I usually start to feel some improvement into weeks 5 and 6.

So basically, you're in the worst spot now and only half way there.

The ball aches will eventually subside.

Do you ever end up feeling as good as weeks 1-2?

 

[Rube99]

FWIW, whenever I make a protocol change I notice that the period around weeks 3 and 4 are when I feel the worst. For some reason erectile function, mood etc are great the first week after a change, week 2 seems "normal", then weeks 3 and 4 I feel off and start doubting my protocol change (even though I've been through this a few times and know better) then I usually start to feel some improvement into weeks 5 and 6.

So basically, you're in the worst spot now and only half way there.

The ball aches will eventually subside.

Thanks! Sounds like me exactly. Was so "up" for the first 2 weeks (placebo effect maybe) and not feeling so great now. Just have to be patient I guess.

 

[Vince Carter]

At this juncture you need to soldier on...marathon not a sprint.

 

[S1W]

Do you ever end up feeling as good as weeks 1-2?

The short answer is yes, definitely.

In fact once dialed in on the right protocol I feel better than I do during weeks 1-2. But for clarification, never as good as the very beginning of TRT - that feeling is dopamine related and for those of you thinking you can get that feeling back and maintain it every day...it's not going to happen.

For an example of the ups and downs, when I first started with my 60mg E3.5D protocol, I felt like garbage. I couldn't sleep, night sweats, was super moody, next to no erectile function...it sucked. After sticking with it for 5 weeks, I started to feel better. After the 6 week mark, I felt great and all of those negative things were no longer an issue.

I was doing great on that protocol but unfortunately HCT was always a bit high over range. It finally crept one point higher to the point that I had to donate, so now I'm back to chasing my tail trying a protocol change hoping that I can find something that allows me to maintain previous levels with lower HCT.

 

[antelopers]

The short answer is yes, definitely.

In fact once dialed in on the right protocol I feel better than I do during weeks 1-2. But for clarification, never as good as the very beginning of TRT - that feeling is dopamine related and for those of you thinking you can get that feeling back and maintain it every day...it's not going to happen.

For an example of the ups and downs, when I first started with my 60mg E3.5D protocol, I felt like garbage. I couldn't sleep, night sweats, was super moody, next to no erectile function...it sucked. After sticking with it for 5 weeks, I started to feel better. After the 6 week mark, I felt great and all of those negative things were no longer an issue.

I was doing great on that protocol but unfortunately HCT was always a bit high over range. It finally crept one point higher to the point that I had to donate, so now I'm back to chasing my tail trying a protocol change hoping that I can find something that allows me to maintain previous levels with lower HCT.

Nice post, thanks. Just out of curiosity, what are your levels on that dose?