Setting Expectations

Low testosterone issues, impacts on health & marriage, treatments, etc.
Hoosier52
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Re: Setting Expectations

Postby Hoosier52 » Thu Sep 15, 2016 4:59 am

Just my two cents...Why not go with Defy and work with a doctor who knows what he's doing? I went through the TRT circus for awhile with an incompetent doctor. Your health and married life are too important to important to leave in the hands of an incompetent. Dr. Saya did the best consult with me that I have ever had from a doctor for any medical issue. You MAY find a local doc who knows what he's doing, but in my experience hey pretty much do not exist. Defy doesn't do insurance, but the out-of-pocket expenses are not that bad. At least give them a call.

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Re: Setting Expectations

Postby SquarePants » Thu Sep 15, 2016 6:19 am

justsomeguy wrote:Saw my doc today. He said there's "no way" my higher E caused any of my recent issues. He said it's all about the T/E ratio, and in my case my ratio was massively high on the T side. So much so that he said T therapy "might not do all that much for me" :shock:.

I am continually surprised at the incompetence of doctors prescribing testosterone. I was surprised when he massively increased your dose from 100 mg to 150 mg/week. He is absolutely wrong in his "no way" conclusion. It's not just about the ratio. Even it is, he's not very good at math, because your T/E ratio is horrible. Your relative estrogen ratio is over twice as high as the point where I experience negative effects of estrogen.

I'm almost afraid to ask: Did he prescribe Arimidex to lower your absurdly high estrogen levels? Or is he hoping that they will drop the acceptable levels by lowering your weekly dose of testosterone to 120 mg/week? If he didn't, I would recommend that you find another doctor ASAP.

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Re: Setting Expectations

Postby SquarePants » Thu Sep 15, 2016 6:22 am

Hoosier, are you checking your PMs? I sent you some questions about Defy. I'm looking for another doctor as well.

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Re: Setting Expectations

Postby justsomeguy » Thu Sep 15, 2016 8:27 am

I'm almost afraid to ask: Did he prescribe Arimidex to lower your absurdly high estrogen levels? Or is he hoping that they will drop the acceptable levels by lowering your weekly dose of testosterone to 120 mg/week? If he didn't, I would recommend that you find another doctor ASAP.


Nope. Only the drop to 120mg/wk :roll:

he's not very good at math, because your T/E ratio is horrible


My last T was > 1500. Literally off the charts. The fact I did not become a raging horndog makes him think I just may not respond well to TRT. My last E was 118, so the ratio was 1500/118 = 12.7 (minimum). On 8/9/16 my T/E ratio was 438/25 = 17.5. That would mean I would have had to have a T of 2065 to maintain the same T/E ratio of 17.5. I suppose that is possible but we just don't know - the lab cuts off at a max of 1500. Seems hard to believe I would have been over 2000 tho.

That said, he has some T/E ratio in his head that is far less than 12 that to him indicates "everything is fine".

I'm going to give him 1 more month and if I'm not good I'll jump ship to Defy.

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Re: Setting Expectations

Postby SquarePants » Thu Sep 15, 2016 10:45 am

For reference, I begin to notice estrogen symptoms when my E2 levels rise above about 30 when my T level is around 900. That would be a T/E = 30. If i recall correctly, our SHBG levels are similar, so we may have similar sensitivities to both hormones.

You may consider looking online for other symptoms of high estrogen. You don't want to go too long if you experience more severe symptoms, such as nipple swelling or soreness. It may take weeks before you can get an appointment at Defy, and they may order additional labwork, so you may want to get the process started. Maybe Hossier can tell us how long his lead time was. You may be able to cancel your appointment of your doctor does some smart things within the next month.

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Re: Setting Expectations

Postby justsomeguy » Thu Sep 15, 2016 12:34 pm

Thanks SP. Will consider that.

I'm curious what all of you have experienced as far as time of day and activity frequency. I've noticed my "crash" episodes seem most like to occur when (a) it's late at night and (b) after we've had a stretch of daily activity for 3-4 days. A bit of an experiment and a bit of circumstances has led us to sexually activity every other day and in the afternoon. Don't know if it's coincidental, or whether I'm just feeling better lately, but these past few "afternoon delights" :lol: have been outstanding. I feel 45 again!

Thoughts?

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Re: Setting Expectations

Postby Hoosier52 » Thu Sep 15, 2016 1:48 pm

Defy is probably a month wait. Dr. Crisler is no longer with Defy, but they have added a new MD and a PA. Give them a call. They are THE best. You'll be relieved to finally talk to someone who doesn't sound like a quack.

The high T and low libido is most likely due to the high estrogen (doesn't look like they did the sensitive estradiol test which is another indicator that they don't know what they're doing.) When I started Anastrozole and my E went down, my libido went through the roof. My total T was 1500.

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Re: Setting Expectations

Postby justsomeguy » Sun Oct 02, 2016 10:11 pm

Update...

The past 10 days have been phenomenal! Zero issues, everything feels great! I've been taking a fish oil & zinc daily supplement. The zinc because someone here said it can reduce Estrodial. Still at 120ml T once weekly IM. Should I rush out to get labs done to see where I'm at or is it safe to assume I'm at a very happy equilibrium & I will stay there?

Such a kind blessing from the Lord to be able to so enjoy my wife again, and even daily if we want to :D

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Re: Setting Expectations

Postby ledgemoor » Mon Oct 03, 2016 5:48 am

Awesome! Be sure to take 2 or 3 mg copper with that zinc. Zinc slows the absorption of copper. Also, on the Vitamin D, I would research optimal vs normal levels. For so many vitamins, the RDA is just above a level which you get clinical symptoms, not an amount which yields optimal health. With the fish oil, it shuold be higher now.

I would get another set of tests now that things are good so that you have a baseline reference for the future in case you ever have problems again. You can order them online here without a prescription and at a savings. Here is the link to the testosterone tests, but they have everything: http://www.discountedlabs.com/testoster ... e-regular/ I would get the tests the day before your injection, and not in the morning -- worst case scenario IOW.

ETA -- was reading and found this -- apparently fish oil doesn't have much Vitamin D? http://www.jabfm.org/content/18/5/445.1.full
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Re: Setting Expectations

Postby justsomeguy » Wed Oct 05, 2016 5:21 pm

Big setback today. No ED but again totally "lost it" during & was unable to finish. So bleepin frustrating. Just when I thought I had this jacked up body beat >:(

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Re: Setting Expectations

Postby ledgemoor » Thu Oct 06, 2016 4:02 am

So sorry.

How long were you erect before losing it? Any distractions? (Such as wife bringing up something totally unrelated to sex...)

Have you tried l-citrulline?

At this point I wouldn't stress about it. It happens. Happening this soon after starting zinc/DIM doesn't mean it isn't a fluke. You might be fine next time.

FYI a mountain biking friend was doing ok on testosterone, zinc, & DIM. But his doctor added some estrogen control (he isn’t sure what -- 2 pills a week), and has lost more weight and gotten faster.
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Re: Setting Expectations

Postby justsomeguy » Thu Oct 06, 2016 7:11 am

I wonder if my Estrodial has crept up again. It's frustrating my doc utterly dismisses the raw E level, and ONLY gives credence to the T/E ratio.

As far as erection, I was going fine for about 5 minutes but I do think there was psychological distraction, or even negative thoughts crept in. I had given her a strong O orally and then she suggested a position that she had previously said didn't do much for her (in that she would never O no matter what in that position - from behind). I don't like to finish in that position either (don't know why but the O does not feel good for me in that position). There's a bit more to the story, but just to summarize, I went from being "hot" to "not" and that's when it became immediately clear I was not going to O.

So perhaps I've again proven that the most important sex organ is the mind :?

Perhaps the combination of E and negative thoughts did me in...

Hoosier52
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Re: Setting Expectations

Postby Hoosier52 » Thu Oct 06, 2016 8:11 am

Your doc is wrong to dismiss the estradiol level. When mine went down, the libido and everything else went up. May be time to switch to Defy.

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SquarePants
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Re: Setting Expectations

Postby SquarePants » Thu Oct 06, 2016 4:41 pm

justsomeguy wrote:It's frustrating my doc utterly dismisses the raw E level, and ONLY gives credence to the T/E ratio.

Not that you need any more convincing, but here's a quote from testosterone expert Dr. John Crisler from his forum:
Ratios are for docs who do not know what they are doing.

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Re: Setting Expectations

Postby Job29Man » Fri Oct 07, 2016 5:29 am

Guys,

This thread has great information, and is an important resource. I just made it a "sticky" which means it'll stay at the top of the subform listing. Keep up the good work.

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Hoosier52
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Re: Setting Expectations

Postby Hoosier52 » Fri Oct 07, 2016 6:45 am

Just got my labs back...My estradiol had risen to 52.1 (sensitive test) which is high. It should be between 20 and 30. I could feel the effects including lower libido and soft erections. I started on Anastrozole last PM. When my estradiol was down, I felt great.

The bad news on my labs is that my PSA continues to climb. My hematocrit was also high and estradiol plays a factor in that and may also play into the PSA. Not looking forward to what the doctor may recommend.

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Re: Setting Expectations

Postby Hoosier52 » Thu Nov 03, 2016 7:10 am

On Monday, I had my phone consult with Dr. Saya from Defy Medical to review my latest blood work. My total T was about 880 (down from 1500) and my free T had gone up. 1500 was too high and not manageable. However, I DID feel great when it was that high. My T and HCG injections will continue unchanged.

My estradiol had risen to over 50 (sensitive test). He put me on anastrozole/DIM capsules to regulate that. I will take one capsule the day of or the day after my injections to regulate it.

My PSA had risen to 4.6 which is a concern. He thinks it may be BPH or inflammation. TRT will also cause it to rise. We will retest all of that in 3 months. If the PSA continues to rise, I'll have to go see a urologist and probably end my TRT until they figure out why it's rising.

The DHEA I am on brought my levels from low to normal. I think it's helping my mood and my sleep.

My wife has also started TRT with Defy and she is noticing some positive changes. More energy for one.

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Re: Setting Expectations

Postby justsomeguy » Wed Mar 01, 2017 2:43 pm

Just an update to this thread: I finally had my Defy consult a few weeks ago (with their new doc) and he put me on HCG, DEHA, and Anastrozole (just started this today). Also oh-so-slightly bumped up my T. I had switched myself from IM injections to subQ a few months ago and I think that helped a bit. So much easier to inject subQ as well :)

Can anyone tell me how long between starting a new protocol with Defy until you starting noticing inmprovement? And mention whether you had been on TRT prior to switching to Defy.

Also, how long did it take until you felt the maximum benefit of the new protocol?

Thanks all!

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Re: Setting Expectations

Postby be64 » Wed Mar 01, 2017 3:21 pm

What improvements do you hope to have? Different things take different amounts of time to see. For me sexual improvements were the first to be seen.

I'm curious what your doses are.
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Re: Setting Expectations

Postby justsomeguy » Wed Mar 01, 2017 4:20 pm

be64 wrote:What improvements do you hope to have? Different things take different amounts of time to see. For me sexual improvements were the first to be seen.


Mostly looking for sexual improvements. I'd like my libido to be back to where it was just 3 years ago (although my wife is prolly fine with where it is now, lol). I also wonder if I'm a bit too emotionally sensitive lately - something Defy asked me directly when they saw my Estradiol #. I think this might affect me sexually as well: if I don't think my wife is 100% on board with sex in the moment, I continue to have a bit of ED or easily lose E if my brain detects anything even slightly amiss. I still suffer from failure-to-finish issues at times as well. Looking for all of that to be a thing of the past.

be64 wrote:I'm curious what your doses are.


T bumped from 0.3 to 0.35 ml (twice weekly)
HCG: 0.35 ml (twice weekly)
Anastrozole: 0.25mg with injections

DHEA - 25mg nightly


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