Hi Vlad, Getting your testosterone optimized with estrogens and DHT controlled within good parameters is where I would start, but it sounds like you have other causes to investigate. Muscle spasms and cramps are the most common reported symptoms in people with low thyroid. Feeling cold is very common, but more important is to check your body temperature in the morning and see if it's 97.6 F or below (not sure You should have that tested including TSH, TOTAL T3 and TOTAL T4. Most people check only the "Free" T3 and T4, but just as with testosterone the free level isn't nearly as important. That's why most hormones aren't even tested in the "free" form, just testosterone and thyroid for some reason (probably because someone influential developed those tests). I would also suggest testing Cortisol, DHEA-sulfate, ACTH, 25-OH Vitamin D, Estrone, Estradiol, Total Estrogens, Prolactin, and maybe some others depending on your history of exposures (heavy metals, industrial chemicals, mold, etc.), dietary habits, and other symptoms you might have. I have to talk to people for an hour before I have a good idea what the causes might be. That would be a good place to start at least. I will attach my TRT information handout here so you can see what I think is optimal.

I can't give you specific medical advice through this format, but it looks likely you might benefit from taking some thyroid hormone. Your TSH isn't above range, so I don't know if doctors where you live are willing to prescribe you some to try; but my strategy is to give people some increment of thyroid (50mcg Levothyroxine or 60mg Pork thyroid (NP, Armour, Westhroid, etc.) per day, then increase the daily dose after a week each time by 25mcg or 30mg pork thyroid and keep going until you feel your symptoms all improve or you go a step too far and feel overdosed (feels like caffeine overdose). If it's something you need the related symptoms will improve and resolve completely when you get up to your ideal range. I have people stop and recheck labs at 125-150mcg T4 or 120-150mg pork thyroid, to make sure there isn't something else going on. I have seen a lot of people with symptoms of low thyroid but normal-range labs, and their symptoms all cleared up taking increasing amounts of thyroid. When we retest their levels they are typically still within the reference range, just in the top 25% instead of the bottom 1/3 or something. We have to treat people first, not lab data. Much better results that way.

We just order whichever brand has 10mL vials of testosterone cypionate (or enanthate, same effect) in 300mg/mL or 250mg/mL on sale. We have never cared what brand it was, they are all selling essentially the same stuff from the same original pharmaceutical factories. Don't stress over it, pick the cheapest one that suits your needs. Buy a different brand each time, it shouldn't make any difference.

No problem. I think I will just post them unedited right afterward, and the social media people can just make some smaller clips from them for YouTube.

It isn't true that testosterone raises lipids, it's actually the opposite. Numerous long term prospective studies on TRT have shown reductions in diabetes/metabolic syndrome, lipid levels, blood pressure, deaths from cardiovascular disease (up to 90% reduction in one 7 year study with about 600 men) and all-cause mortality. It doesn't sound like something people should be afraid of, does it? And yet, the teaching I received about testosterone during medical school and residency was almost all negative and nobody ever prescribed it or taught me how to use it. After researching those common concerns (cancer, heart disease, blood clots, etc.) I found no published evidence that any of it was true; in fact, we are finding out recently that the opposite is true for CVD death and cancer. Testosterone causes your body to build up healthy lean body tissue (muscle, bone, skin, organs), which uses up raw materials. Cholesterol is primarily used as a key structural component of all cell membranes, so when anabolic steroids go up the lipids go down. Injuries heal up, even shoulder or low back injuries men have had for over a decade. If you want to research something I suggest going to PubMed and searching for published scientific research regarding your questiong. You will find the most of what people say online is not supported by the current evidence, and in some cases it's completely opposite.

I never bother to check lipids myself on anyone and haven't for more than 15 years I'm sure. Testing lipid levels and prescribing drugs to lower them artificially (your body produces cholesterol for a reason, to repair injured or diseased tissue - you NEED it for many cellular functions) does not reduce death rates from any cause in the general population as primary prevention. Cardiovascular disease deaths are rising worldwide in spite of throwing drugs at lipids for several decades now. That whole philosophy was never valid, just a way for drug companies to convince unwitting doctors who don't read studies critically to prescribe statin drugs for 1/3 of the population until they die. Lipid levels and glucose levels tend to run high in people with androgen deficiency because they aren't using the raw materials to rebuild and rejuvenate lean body mass. When you get your anabolic steroids up to optimal levels and metabolism increases the lipids get used up faster and levels go down. When you correct lipids that way, with diet and lifestyle measures plus hormones if necessary, people live much longer and have major reductions in cardiovascular deaths. When you just artificially force lipids down with statin drugs or others people don't see any real benefit, just a lot of side effects and expense for the system. High cholesterol is merely an indicator of a problem, but not the problem itself. You have to fix the upstream problem, and TRT tends to do that. Multiple long term studies have shown a greater than 50% reduction in all-cause mortality when men use TRT.

We cannot directly prescribe testosterone because it's a controlled substance through the DHEA (schedule III still until they officially change that) and you need a prescriber in your home state with an active DEA license. We can prescribe other hormones and the medications needed to control estrogen or DHT metabolism, order labs when they are needed, and give you whatever advice you need about adjusting your TRT dosing or the other medications. We tell people about a few websites where we have ordered testosterone and you can find an online seller through the "gray market". It's not hard to acquire, but there are peculiarities to those websites like only accepting wire transfers, cryptocurrency, Venmo, Zelle or other similar forms of payment. No credit card or bank tranfers. If you find a source and get some testosterone, I would suggest starting out injecting 250-300mg every three days, and plan to do the labs I suggest right after two weeks. You can talk to one of us about things any time you'd like, before you start or after you have those two week labs done.

That is the best philosophy of TRT I've heard from another clinic so far - good for them! Does Defy Medical operate in all states?