What would my “true trough” be – Wednesday morning, right before my usual injection time? Sadly I have work at that time, so I can’t do that.
Yes, right before your shot. If you can’t do it, I guess skipping the shot would be the next best thing? I’m not totally sure.
I bet it would be fine skipping… I inject at 10pm at night. There is no way I can get my true trough. I’ll have blood work done at 3pm, 7 hours before my shot.
I just don’t think it matters that much since you’re probably pretty stable anyways. But I guess if your other results tend to be at trough then I’d try to do it before one of the shots. Or skip one if it only changes it by 12 hours or something… can’t be that big of a deal, just note what it was so if you’re looking at results a year from now you remember it was a little after your normal injection, etc.
Thanks, fellas – Doc said to skip the Wednesday injection. Appreciate your help!
I’m viewing my next steps in two phases:
- Immediate actions
- Long-term actions
Right after blood draw Thursday AM, I plan to cut off Danazol and increase my T dose from 200 mg injected IM 3X per week to 250 injected SQ ED.
Hopefully this will get me back to some semblance of normal while I figure out next steps. That will be based on the bloodwork and discussions with my wife about Tier 1.
Nice! Set the oven timer on the roast for 8 weeks and don’t open the oven door to peek at the roast until the timer goes off - let it cook!
Side note - had my injection last night and par for the course, I’m 100% high-t Rudd today. Great thoughts and ideas effortlessly flow into my head. I crushed meetings I had today. I want to feel like this every day.
I find it hard to believe people who have naturally high testosterone feel as good as I do right now, but if this is how it’s “supposed to feel” with good T levels, I’ve been deficient my whole life.
Good luck with the adjustments!
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You are going to get there, brother! How much is each one of your injections again? I find it fascinating how you can ‘feel’ the T based on injection timing but I’ve never felt a difference. Have you tried injecting at different times of the day?
42mg EOD, sub-q right now. I almost feel a buzz when it starts working. Have you ever watched Limitless on Netflix? There is a pill, NZT, that’s supposed to allow it’s taker to be able to use 100% if their brain. Usually the scene starts dreary and after the character takes the NZT, the screen becomes more colorful and vibrant and the taker turns into High T Rudd.
I feel that way when the test starts working. Mental clarity, energy, confidence - I notice I look people square in the eyes and easily do this the whole time having a thoughtful conversation. Hard to describe, but I can tell the day after a shot, I’m going to have a good day.
I absolutely know what you’re saying. The high-T feeling is incredible! I can’t imagine what it would be like to have that feeling all the time – you’d be truly unstoppable. You’d win at life.
I wonder if any “dialed-in dudes” who really have their protocol nailed down do feel this way every day, and have for a prolonged period. What a life. That’s what we’re chasing, brother – eternal High T Rudd.
I haven’t seen Limitless but have heard it’s amazing – adding it to the must-watch list! I’m a big Bradley Cooper fan. Appreciate the recommendation.
Has anyone heard feedback on Dr. Jeffrey Ruterbusch? He seems to be getting Nichols-like love, and I wonder what it’d be like to work with him as compared to Dr. Keith. Plus: I will be in Florida in the spring, so I could visit his office in-person.
I think @dextermorgan is pretty dialed in. My goal going daily @bkb333 is to feel great every day and have a perpendicular woody like Dex has. While I’ve been performing much better in bed, I still have a lingering fear things will revert and shit won’t work… I am sick of worrying about it and want perpendicular rebar to show off to my wife on the daily.
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I would advise you to spend a 1 hour consult talking to Dr Saya one on one before you make statements like this. You really have no idea what you’re talking about here bro.
@bkb333
Sorry for the late reply. This whole house thing has got me crazy busy now.
Question…you have obviously been all over the map with protocols and different meds/compounds. You haven’t really stuck with any one protocol or method long enough to really tell much of jack shit about it.
You guys have to understand that dialing in is about optimizing serum levels (the whole 6-8 weeks thing). Once the levels are optimal, and stable, THEN your body can start repairing itself, which can take considerably LONGER time wise (months to YEARS for some things). Every time you change something, you knock things into a tailspin and your body has to refocus on trying to stabilize, and healing takes a back seat yet again.
Here’s that question…
Brother in all sincerity, have you spent as much time talking to Dr Saya about the issues you are experiencing now, and asking his advice as you have posting on this forum? If the answer is truly yes, then you may want to see about finding a different doctor who is more suited to your particular case. If it is NO however, then I would suggest you do that, and actually give his EXACT advice a try for at least a few months. If you still have issues after that, contact him AGAIN. Every case is unique and your doctor has to grow with you. They don’t just have a magic pill sometimes. They have use their knowledge and experience to guide you down a path, and sometimes change things along the way to suit your individual circumstances. All you have to do is call the office or email one of the office staff, and they will forward your questions to Dr Saya. He will respond I promise. It takes a day or so sometimes, but he will respond.
We tend to get on forums like this and start looking at our doctors as T-Mills. What I mean by that is that we only go to the doc for the prescription, and then actually do whatever the hell some stranger in an Internet forum tells us to do and completely ignore what the doctor said.
Now granted, this reputation is well earned by a SHIT TON of doctors, and a lot of them truly are ignorant to TRT best practices, but don’t throw the baby out with the bath water here. Don’t demonize every doctor out there that prescribes T based on this generalization.
You’ve dialed in your diet. You exercise like crazy. Your body RESPONDS to that so obviously the protocol is doing something. You just need to get the last tweaks done man I have a feeling that you’re close but you’re not quite there. I truly believe that you’re not as far off as you think. I also believe that E2 has nothing to do with what you’re dealing with now. You have a very low BF, so you aren’t aromatasing much, and you inject T so you’re not making any in the testicles. The only way your E2 could be high enough to throw your ratio that far off, under these circumstances, is that you are introducing estrogen producing chemicals via diet or other atmospheric phenomena.
We want to go by “feel” yes, but you still NEVER want to make a decision without pulling blood work. We don’t live by numbers exclusively, but when you “feel” off, the number can tell you whether or not you are chasing your tail. You wouldn’t believe how many guys have thought they “felt” high E2, took an AI, and CRASHED their E2 causing extensive (not to mention painful) joint issues that take a long time to recover from. Don’t be that guy…If you suspect something is off, get bloodwork and confirm that before doing anything stupid. And for Christ’s sake, if you haven’t done so, send Dr Saya an email and just copy / paste every post you’ve made in this thread. See what he has to say about it.
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I sincerely appreciate you taking the time to write out this thoughtful and measured response, brother – you have been such a huge help through this HOT process. I’m grateful for you.
I’m in an emotional, reactive place right now, because I’m desperate to ‘feel good.’ This has been a journey but I’m in a low place at the moment – the sunken place! – so I’m probably not thinking straight. It’s hard to come to grips with that, but it’s reality. I just want to ‘get fixed’ ASAP, and I’m being impatient like a child.
But I know that won’t work. In fact, rushing between protocols will significantly harm my progress. Slow and steady…
The answer is an absolute ‘no’ – in fact, I’ve never spoken with Dr. Saya, but rather a PA. Have you always worked with the doctor?
After considering your advice, I’ve decided he’s really the resource at Defy I need to work with. I figured consulting with a PA would be essentially the same thing, as they ultimately are trained by and report to Dr. Saya, but it probably isn’t. I probably need the head honcho.
I wrote out a detailed draft of my situation and will be sending it to Dr. Saya once I have updated labwork (pulled Thursday, should have it next week). I said I’d be happy to pay for a consultation but am still hoping for him to read the email, to see it all organized in one place. It’s harder to recap all this information when you’re just talking off the cuff.
I am especially looking forward to seeing the thyroid numbers. That may be the lynchpin in all of this, because even when my T numbers were through the roof, my libido was lacking. You would think that with a Free T of 54, I would be going nuts in the bedroom, but it really wasn’t the case (at least on a consistent basis).
Man, this year has been such a roller coaster.
This is so encouraging to hear. Just gotta stay the course! I know if I do, I will be into High T Rudd mode before I know it.
This is probably the main reason I’m confused. My PA at Defy has been convinced all along that estrogen is the root of my problems – the main reason I have no sex drive. This, though consistent with a lot of bro science on forums, runs totally counter to what Rouzier, Nichols, etc. preach. So I’m rattled by the mixed messages and unsure who I should be listening to.
I’m hoping Dr. Saya can set me straight. Fix me, doc!
Lastly, I think it might be time for a forum detox – to step away for a bit. As helpful as all the information and banter can be (I love it more than anyone), it can also feel overwhelming when you don’t know what you should be doing. There are so many opinions – all that can be elaborated very reasonably – out there. It can easily fuel paralysis by analysis.
Even if I do take a break, though, I’ll of course keep everyone updated on my numbers and plan of attack.
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Same. You can find someone that agrees with pretty much anything if you look hard enough. It’s tough to know what to do. Honestly sometimes I think trial and error works as good as anything in situations like this.
My first consult at Defy was with a PA and she recommended boron for my 150+ SHBG. I know she was trying to avoid starting me on TRT if possible but the chances of that working were very, very low. I’ve paid the extra to meet with Saya since then. Many people have had great (and less expensive) experiences with their PA’s, but my personal opinion is for more difficult/oddball cases Saya is the guy to talk to there. I‘d give him a chance before switching docs
I’m learning to agree with you on that – no one on the internet has the answers, because no one has the same body. I guess we all may just need to try the ‘best practice’ approaches and ‘the good shit sticks.’
Man, not trying to be rude to her, but that seems incredibly dumb. At least they started me on HCG + AI (though the odds of that working were also very low).
Indeed, that’s my move!
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Not trying to bring defy into the comparison. I get He is your doctor And many more… Dr saya is great.
The difference is night and day between any clinic and a actual doctor who treats like a physician would treat.
Defy you meet with somebody else than saya. Just like @bkb333 stated. Shouldn’t saya be on top of the hard problems. This person is telling him estrogen is the root of his issues while he sits there with super high SHBG and high rt3. They are setup for high volume. Quantity over quality. That’s smart because most men just want T and not much else.
Tier 1 docs meet with the patient until they are happy with the meeting (day 1). He wouldn’t have to ask for the doctor. That’s who he would conversant with. Or dr Howell if Nichols isn’t available. You develop a relationship with the doctor. You can communicate with him on the fly after the first meeting. You do not have to pay them every time a question arises and you want a doctors consult. Level of care is vastly different.
It’s just two different types of business. Many can get away with a clinic. All they need is T.
If you are a female you meet with Angie And she’s just as experienced and learned under doctor rouzier. They both trained directly with rouzier and are actually friends of his and speak to him on the regular. A man who has Made it his life focus to train the medical community. The guys regularly called as the expert in HRT. Whether folks agree or disagree with some of his methods.
Doctor saya is intelligent. What doctor is not? But their is a big difference when it comes to a trt clinic and setup like tier1.
For our brother he needs some help with high SHBG and rt3 now. they just added on Scott Howell and he’s the perfect brain for this guys case.
I don’t disagree with you, but you are not considering a few “key” points…
- Who you speak with at Defy is your choice.
- A situation cannot be escalated if the patient is not giving proper feedback to whoever is managing his / her case.
Unless you are calling them up every 5-6weeks (or as soon as you know something is not agreeing with you) and saying “HEY!. This isn’t working!”, then they are going to assume that everything is going as planned. ALL of these places that treat outside of their immediate area are set up for high volume. That’s just the nature of the TRT world. It’s up to the patient to be proactive in speaking up when something is not going the way it should. The doctors are not clairvoyant.
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Got it. I agree he should speak to a doctor when the issues get complex. I guess he didn’t realize he could.
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You should always be able to speak with the physician at no additional costs. Everyday if you want
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Hope that’s true, not sure how Defy determines what counts as an ‘appointment’ vs. just asking for an opinion.