I’m proud to announce Defy Medical as a Peak Testosterone site sponsor. They are one of the few TRT-related enterprises that I would have as a sponsor for several simple reasons:
a) Many men on the Peak Testosterone Forum have gone to Defy, and I have not had one complaint. True story.
b) You simply cannot find doctors more knowledgeable about testosterone and general men’s health issues than Drs. Saya and Crisler.
c) Their prices are very reasonable. Clearly, they are targeting the “little guy” and not going for the strictly wealthy clientele.
Why I Switched to Defy for My TRT
I switched to Defy for many reasons, but I’ll start with a few stories from my latest visit to my PCP (Primary Care Physician). I was using my PCP to run my TRT program, because one of the doctor’s in the practice allowed me to do subQ (subcutaneous injections) and seemed favorable to TRT. However, this doctor left the practice, so I felt like I was back to square one and wondering their current policy toward TRT.
The first person that I talked to was someone that I thought was a PA but was actually a nurse. She brought up TRT – “are you still on testosterone cypionate?” - and so I answered and asked if the doctor was now allowing men to use HCG. She said, “You mean like the diet?” So I could tell right away that she had no idea that men used HCG as an adjunct to TRT to keep their testicles functioning and of a normal size.
She then added, “I think that some of the bodybuilding guys use it for muscle.” I could see the look in her eyes thinking, “S-T-E-R-O-I-D-S.” Now I have never used steroids and completely disagree with going supraphysiological. I actually keep my testosterone in a relatively low range for a guy on TRT (650-800 ng/dl), so I did not like where that was going. Fortunately, she dropped the subject. After all, she clearly did not even know that low dose HCG does not even raise testosterone that much in men on TRT.
In a few minutes the actual PA came in and things went little better. He told me that he wanted to pull my testosterone but that I would have to come back in the morning to get the labs pulled. My jaw dropped in disbelief, because their office is about 17 miles from my house. I asked why and he said – and I’m not kidding – that that was the time of day for a man’s peak testosterone.
Of course, I immediately explained that that was only for natural men NOT on TRT. If you are on TRT, your plasma levels of testosterone have nothing to do with morning or evening but only when your last injection was. Anyway, after five minutes of trying to explain all of that and desperately trying to get out of 30+ miles of needless driving, he finally agree to pull the labs while I was there. But I could tell he thought that I was up to something. Oy vay…
NOTE: No hard feelings towards my PCP by the way: most PCP’s are woefully lacking in training on hormones.
Meeting with Dr. Saya
Now let’s contrast that with my meeting with Dr. Saya. First of all, Defy pulled more labs before my meeting with Dr. Saya than I had ever had pulled before. And Dr. Saya had clearly read and reviewed the labs before my meeting He asked me a number of relevant questions, and he was able to draw on his expertise to put me on a much more cutting edge protocol that I believe will be much more safe and successful in the long term. Here are some examples that show the huge difference in care when I went with Defy:
1. HCG. I asked Dr. Saya about HCG and what a contrast with from my PCP’s office! Dr. Saya cited some recent informal study work on HCG and how to determine the optimum dosage for men. He mentioned having to monitor estradiol afterwards and many other great ideas. And, most importantly, he also emphasized the importance of having HCG potentially in order to keep the testicular production line running in case you ever have to go off of TRT.
2. DHEA. About 7-8 months ago, I had tried 25 mg of oral DHEA, because my DHEA-S iies in the lowest part of the lab’s DHEA range. This amount seemed to be the right level, and I felt that it lowered anxiety and gave me a sense of mental relaxation. However, a couple of months afterward, I took my PSA and it had jumped a little. To play it safe, I immediately quit.
Based on my description as to what happened, Dr. Saya was able to comfort me with the fact that he felt it was quite unilikely that the DHEA raised my PSA. He even recommended that I try it with 25 mg of the oral form again, which I agree to, because it was the only one that raised DHEA-S, an important reservoir for DHEA. Also, I liked the very reasonable dose of DHEA that he recommended (25 mg), since it should raise my DHEA-S to midrange or a little above – right where I would like to be for anti-aging purposes.
3. Pregnenalone. Dr. Saya also recommended that I try 25 mg of pregnenalone. This is the “master hormone” from which all of the other “common hormones” are built. He pointed out that taking this in combination with the DHEA right before bed can really improve sleep. That sounded good!
4. Estradiol Monitoring. My guess is that 98% of urologists, endocrinologist and PCP’s do not pull estradiol in their male TRT patients, either before or after the initiation of treatment. This is a huge blunder, because a recent study (and countless stories in TRT clinics and online) have shown that estradiol is clearly just as important as testosterone when it comes to sexual and brain benefits. Dr. Saya totally understood this, ordered the correct estradiol test and even commented on the results.
5. Extensive Testing. The thyroid testing that Dr. Saya did before the initial consult was the most thorough that I have ever been given. Thyroid treatment is quite an art, if you will, and Dr. Saya was clearly well-versed in the subject. He suggested that I pull reverse T3 sometime soon just to play is safe, since at times I have had some signs of hypothyroidism. Again, that is something you would probably not hear from a PCP, or even some endocrinologists.
6. Compounded Pharmaceutical Products. One thing that I really appreciated was the fact that I was going to be given a pharmaceutical grade DHEA and pregnenalone. He explained that I would not have to worry about fillers in the capsule or inaccuracies – this would be within 99.5% of the value on the label.
7. TRT Termination. I also discussed with him under what circumstances he would take me off of TRT. I had found out the hard way that this is an incredibly important topic: my last TRT clinic noted a rise in my PSA and immediately took me off of TRT with no warning. A month later my testosterone was 121 ng/dl! Dr. Saya explained that, based on my description as to what happened, that he would have allowed me to stay on TRT until I had been evaluated by a urologist. This is a much more reasonable approach in my opinion. (NOTE: This is not true in all circumstances however. Some not as common cases require TRT to be immediately terminated for evaluation.) I thought Dr. Saya’s responses were very reasonable and not being dictated by a backroom attorney somewhere. Kudos to him.
The bottom line is that you can see that Dr. Saya came up with a very well-rounded TRT protocol that included multiple hormones and the safest ones (in my opinion) at that. He also showed extensive knowledge of men’s hormones. To be honest, what was very enjoyable for me was that I was learning while I was listening to him as opposed to me trying explain Testosterone Therapy 101 to the PA and nurse at my PCP’s office. Finally, freedom from the very lackluster and negligent insurance-backed healthcare system…