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Geez, dude. What happened?
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I like Dr. OāConnor, too. Consumed lots of his content over the years, and I can see why youād say heās conservative and long-term minded. I havenāt explored his practice but he strikes me as a good doc to work with ā though I imagine, given the growth of his public profile, he probably isnāt doing much hands-on work these days. Have you worked with him?
I also understand the ācookie cutterā argument against Defy, which comes up a lot. Itās fair. I was initially placed on a protocol like that. However, it seems to me theyāre willing to work with you if you want something different. You do, however, need to be proactive and do lots of your own research. I like that theyāre organized from an organizational perspective. They seem more buttoned-up and professional to me than the other TRT placesā¦though the name (Defy) is still kind of annoying 
Lastly, I like Mike! Heās a good dude. I suppose this comes down to the eternal ātheory vs. practiceā argument. A doctor may not be jacked, and Iād prefer my provider to look like he lifts, but I donāt think thatās a good reason to rule him out. Itās kind of like in sports ā some of the best coaches never played.
I trust he will release entertaining content for me to watch
I also thought Mike was good when I was with Defy. He gave me flexibility in my protocol. Saying stuff like if you feel like this stop using X in your protocol until we pull more blood work. When I told him my lifting numbers he was like letās bump up the test a bit and see what happens. Donāt work with him anymore, but he was good.
I do think your complaints about Saya are a bit unjustified. I think he uses protocols that works for most guys. Look at what you are paying for. Blood work and an hour consultation in which a script is expected. Pretty hard for a guy to get it right with every single patient. If you are one of the guys that canāt just shoot some Test and feel a bit better and get a better body, then you probably want an in person doctor.
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I understand why heās frustrated and also think youāre right that he needed an in-person doc. This is one of those wrinkles with telemedicine that still hasnāt been figured out. I see it more as an issue with the model than with Dr. Saya himself.
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I donāt think saya is as good as people on these online forums tend to think. He is VERY cookie cutter and needs to be called out for that. Its like I was talking to a robot when talking to him, and to be quite honest, I felt like I knew more than he did. I took his advice because of the good reviews, and I paid the price for not going with my intuition about some of the advice he gave me. For god sake the man suggested clomid over Enclomiphene at one point because he said it would raise my shbg. What doctor do you know would suggest a dirtier drug just to raise shbg? Heās complete bullshit as far as trt doctors go, and I would much prefer one of these more knowledgeable providers that I have already mentioned.
Does Enclomiphine not raise SHBG?
I havenāt worked with āanabolic doc.ā But I admire his strategies. Heās very methodical in his long term approach, which may have many believing that heās a bit too careful, but I like him. You should watch his videos about men with high cholesterol on trt. He uses a small EOD dose of crestor with some other ancillaries (like vascepa). Statins are not the terrible drugs your doctors tell you they are and even provide longevity and anti inflammatory benefits if you can withstand the side effects (if any from such a low dose).
They both probably do, but I think because clomid has an estrogenic component that it might raise shbg more. I think thatās why he suggested that but wtf.
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Gonna be real with you, brotherā¦I really wish things had gone better for you, and obviously I donāt know all the ins and outs of your situation, but I think youāre being a little hard on Saya.
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For anyone interested in the info @Gandalf recommended from the Anabolic Doc on cardiovascular risk on TRT.
TL;DR: monitor your BP and understand testosterone can be hugely risk if not administered properly.
Thoughts on best timing for dosing Tadalafil? Iām taking 3 mg per day, primarily for BP, but the ED effects might be a nice potential side.
Anytime, itās got a fairly long HL and builds up over 5 days or so to peak
Edit: just FYI I take 2.5mg daily and donāt see much change in BP. I take 10mg Telmisartan for that and it has a big impact
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Great to know brother
Podcast recommendation: Matt Walker on Huberman. I liked Why We Sleep but think this appearance is even better than the book.
I started reading why we sleep by him. Tough book to get through 
Good read but one of the most dense books Iāve come across recently. Heās better on podcasts. Love his passion for sleep!
Iāve gotten into charting my sleep lately with an Oura ring. Looking for strongest correlating factor between kcal, macros, activity level, sex, hormones, sun exposure, stress, etc.
Sleep score is usually ~75, which isnāt terrible, but Iād love to get above 80.