Thanks @Ty Vincent. Not on growth hormone (never have been) or any peptide that would impact insulin. DEXA on 9/2 (Lunar iDXA): 174 lb at 10.1% body fat, 150 lb lean mass (about 86% of bodyweight is lean), RSMI 10.6. I sauna 3–5x a week, and I've pushed salt recently. On insulin: 3.7 in July and 4.1 last month, with fasting glucose 80–82. What do you usually do with patients to move fasting insulin from the 3–4 range down toward 1? I'm not currently avoiding plastics, non-stick pans, etc. Curious, are any of the tests from PlasticTox, MicroplastX, Blueprint's worth using (e.g. for a benchmark)? Or something like a PFAS panel?

@Ty Vincent very cool. Thanks for posting those. Would it be possible to put comments on the videos to ask questions? Or should we just post here?

@Trent Granger the handout above is very helpful. Ty will give you the definitive answer, but his number that comes up again and again is the two added together: he wants Estrone (E1) plus Estradiol (E2) summed in the 50–100 pg/mL range. He's said some men feel better nearer 80–120, and he's said that pushing the sum under 50 makes you feel awful in a way that looks a lot like low testosterone. The part most clinics get wrong is only running E2. Estrone can come back two or three times your estradiol, and there's no fixed ratio between men, which is exactly why he treats the sum. Good that you're getting both. For what it's worth, my last panel (Aug 28) had Estradiol 60 and Estrone 68. Summed, that's 128, so a bit above his 50–100 band, though he's said you should go by how you feel rather than chasing a range. If yours comes back high, his rule of thumb is roughly 1 mg of anastrozole per week for every 50 pg/mL you're above target, spread out over the week — then retest in 2–3 weeks and adjust from there. A few threads of his worth reading: E1 + E2 target range — https://www.skool.com/drtyvincent/new-here Why both forms get tested — https://www.skool.com/drtyvincent/estrone-serum-immunoassay-vs-lcmc-tests Anastrozole dosing and when to retest — https://www.skool.com/drtyvincent/doctor-says-dont-use-anastrozole-do-you-agree

@Heitor Cruz I can't speak to Utah specifically, but I've used Defy Medical (defymedical.com) for my HRT and it's been a great experience. They're telemedicine and everything is legitimate and above board. What I appreciate most is that they don't get skittish about the things a lot of clinics panic over. My total testosterone is 1,764 and they've been fine with it. My hematocrit is 53.6% and hemoglobin 17.7, both top of range. Nobody has told me to stop or cut my dose over it. When my estradiol came back high, they prescribed Anastrozole instead of just lowering my HRT.

@Ty Vincent they say they operate in most states, though I haven't found a list of which states specifically. @Heitor Cruz you can contact their team directly by phone at 813-328-2335 or via email at Care@DefyMedical.com. They've been responsive to me for all my questions and orders.