Hi Everyone, I recently had a consult with Defy and they’ve put me on a new protocol. I just want to be sure that I’m setting myself up for a decent result. It’s been a year of hell for me but it sounds like people on this forum are confident in Defy. New protocol is as follows:
Test Cyp SubQ 30mg EOD
Anastrozole .125mg Twice a week
Here are my most recent labs:
Endocrine:
Total Test: 181 Range 280-1100 LOW
Free T: 4.64 Range 1.9-27
E2: 20.1 Range <40
Dhea: 483.6 Range 34.5-565.9
SHBG: 15 Range 14.55-94.64
LH: 2.1 Range 1.5-9.3
IGF-1: 304 Range 137-199 HIGH
Thyroid:
Reverse t3: 20.7 Range 8-25
T3 free: 3.7 Range 2.3-4.2
T4 free: 1.77 Range .89-1.76 HIGH
TSH: .536 Range .55-4.76. LOW
Thyroid Peroxidase abs: <28.0 Range <60
Thyroglobulin abs: 23.4 Range <60
Coronary:
Triglycerides: 78 Range <150
Total Cholesterol: 130 Range <200
HDL: 38 Range >40 LOW
LDL: 76 Range <100
Chol/HDL ratio: 3.4 Range <5
I can’t understand going on a Ai without first seeing what your e2 is after you start the protocol. Or how you’ll feel, which is more important than the number.
However, Defy knows more than I. So do what they say.
See, that’s what I was thinking with the AI. Defy stated that based on my history and current blood work that I’m likely a high aromatizer and would need the AI the begin with. I’m worried about crashing my E2 but I was told that my dose is really low.
Low SHBG guys have a ton of free testosterone and free estrogen, knocking estrogen low wasn’t as bad as others have described it, an E2 of 12 and I still had limited erections do to having a lot of free estrogen.
The only question remaining is are you an over responder to AI’s which can make this alot more difficult. I imagine many have quit TRT just for being AI over responders.
Defy Medical usually tells patients to hold off on the AI until symptoms are present, estrogen may not be a problem for the first couple of weeks. It usually takes 6-7 weeks for estrogen to start becoming a problem for me when starting a new protocol.
When a stable state is reached estrogen rises quickly for me.
I’m sure your doctors will be thrilled to have their treatment questioned by some guys on the internet. I’m guessing that with your E2 pretty decent, 20.1, with such low testosterone they assume it will jump once testosterone does. However, I agree the anastrozole is premature, especially since they are not able to do a physical exam. I’d hold off.
My question is in regards to the elevated IGF-1. Was that addressed? Did they check prolactin levels?
Just asking some questions, not planning on going off the rails with treatment and creating my own regimen. Like I said in a post question, going to check in with Defy again tomorrow over my concerns, thought I’d get some ideas on what to ask specifically. Yes, they were indeed concerned that my E2 levels would increase almost immediately after testosterone administration.
IGF-1 was addressed and I was told that they are ok with those levels, prolactin was not checked.
I know defy is on the cutting edge why wouldn’t they run prolactin to at least get a baseline. What if you have prolactin tumor cause low LH output? They do check igf maybe because if it’s low or mid-range they can offer gh . If high prolactin and high igf that requires further investigation. Look it up.
Also why no base line with dht?
As far as the ai . I think you should wait 6-8 weeks. It will probably jump initially but should level off. I personally would want to know what the number is without ai- at least initially.
Also maybe I missed this are u on thyroid meds? Your TSH number may be a reason why shbg low?
And In fact, low SHBG can be used as a marker of insulin resistance. Will they check your glucose,insulin , a1c level?
Hi Charlie, not sure why prolactin wasn’t ordered this time. I was under the care of a Urologist, that ended early this year. Maybe Defy thought the Uro would have ruled out a tumor, not really sure. Also not sure why dht wasn’t ordered. The Uro did order prolactin tests. The results were:
As far as thyroid meds, no, I’m not on any. Defy did find my thyroid results to be off but wanted to tackle the testosterone first. My glucose, which they did test, was 86, fasting for 13 hours. I’ve never had my a1c or insulin levels checked. I’m 30 years old, 6’ 180lbs. My glucose levels have been wacky for a few months now on tests orders by my PCP, but they said it’s probably due to a couple ear infections I’ve had.
why wouldn’t they run prolactin to at least get a baseline. What if you have prolactin tumor cause low LH output? They do check igf maybe because if it’s low or mid-range they can offer gh 