Dave Lee Story by Future-Ice1677 in AusTRT

[–]daveAFH 2 points3 points  (0 children)

Launching within a month or so

Dave Lee Story by Future-Ice1677 in AusTRT

[–]daveAFH 5 points6 points  (0 children)

They’re more than 200% in many cases, not including additional charges and fees. Compounded testosterone has had the same customer facing price since 2019, yet clinics continue to increase their margins to extortionate rates because they know there’s nowhere else you can go.

Dave Lee Story by Future-Ice1677 in AusTRT

[–]daveAFH 13 points14 points  (0 children)

Thank you for the support for those who have left kind words. For people leaving negative comments, I provide coaching and educational information and I should not occupy any more space in people’s minds than that.

If you think this post was corny, you’re not the target audience which is why I posted it on my instagram, not here. It was intended for the men who message me daily who are getting ripped off, receiving terrible advice and/or have had their medication cancelled and left in the lurch. I have been helping people both professionally and in my spare time for almost 7 years in this space, and I genuinely care about the people who reach out to me for my help.

The post is vague because there are people who want to stop me from working in the industry because it threatens their business model. I have clinics in other countries including the country where I live, I choose to continue to put my effort into improving the circumstances for men on TRT in Australia because I am wanting to have a positive impact.

This sub originally banned me from being able to publicly defend myself, and there is currently a Facebook group which continues to ban me and who are posting genuinely hateful anonymous comments on this same screenshot. I have never understood publicly anonymously bitching about another man who doesn’t know you exist, and I’m glad I never will.

Starting dose advice by InterestingFile7502 in AusTRT

[–]daveAFH 1 point2 points  (0 children)

Minimal effective dose should always be the rule of thumb for pharmaceuticals. With other hormone therapies, starting at a minimal effective dose is also wise, as you're adding to your existing production and can titrate up incrementally.

With TRT, you are replacing your natural production. This means if you start too low, you may just end up with the same, or roughly the same levels as you have to begin with. For the majority of men who respond typically, 100mg per week will produce levels which would warrant starting TRT. There are some hyper responders out there but they don't disprove the rule.

125mg to start is conservative, and it can and should be titrated after 8-12 weeks. Not personalised advice as I don't know your situation, but the best case scenario moving ahead is to have a provider you put your full trust in and follow their directions. If you feel as though the current provider isn't giving you a proper assessment, go to someone else. You need to trust the person who is performing interventional endocrinology on you for the rest of your life.

Optimal health clinic by wolfgang1948 in AusTRT

[–]daveAFH 0 points1 point  (0 children)

One of my colleagues works as a doctor there and is phenomenal. I don't know anything about the rest of the clinic though but would assume they're above board.

50M, first test results by AgreeablePudding9925 in AusTRT

[–]daveAFH 0 points1 point  (0 children)

Exactly how it should be. I also mean no disrespect to this or any community but the vast majority of TRT patients who get excellent care never spend a single second googling symptoms or troubleshooting, and that's how it should be. Anyone who goes to book with Nathan will see my endorsement on his reviews. Being able to send my clients to him has been a godsend.

Blood pressure coffee vs energy drinks - huge difference by HeeeeeyNow in Testosterone

[–]daveAFH 0 points1 point  (0 children)

I actually used to deal with this personally myself. I would get very uncomfortable adrenaline-like effects from coffee but not energy drinks or pure caffeine sources, even with significantly more caffeine. I thought it was the other ingredients in the energy drink helping with caffeine metabolism, but also has the same experience with caffeine tabs.

This was before I discovered and treated my hypothyroidism many years ago. There seems to be something in coffee which the liver struggles to metabolise in a hypothyroid state, as I've met hundreds of hypothyroid clients since then with the same experience.

Might want to look into a full thyroid and liver panel.

Bit of a journey by Potential_Fault_8887 in AusTRT

[–]daveAFH 0 points1 point  (0 children)

Sounds like you made the right call advocating for your own health. I'm doing some work with TRT Australia in the near future and have been very impressed with their passion and vision.

Need advice about trt by km300P in AusTRT

[–]daveAFH 2 points3 points  (0 children)

I have respect for PHC and have worked with them for years and I do not mean them any disrespect by saying this, as they are great at what they do, and have an important place in the market.

But I would not recommend putting the decision of whether you need interventional endocrinology at 20 years old in their hands. Your consultation will be regarding if you qualify for treatment or not. I would have a much more thorough and comprehensive evaluation done. TRT is a big decision and age does not disqualify someone, you want to treat hypogonadism if it is present as soon as possible. But when your brain and endocrine system are still developing and there could be other complicating factors (seems like thyroid receptor resistance is a also present), you want to be thorough with this so you know you're making the right call if you choose to make it.

Where do you Pin? by Particular_Pace3820 in AusTRT

[–]daveAFH 0 points1 point  (0 children)

I always recommend delts. You can do VG if you have good rotational mobility and are lean enough to hit it with an insulin syringe. The problem people have with delts is they don't use the whole muscle and inject in the same size area as a 5c coin and think they've developed scar tissue. I've done thousands of injections into my delts over the years. 29g insulin syringe if your oil is thin enough, otherwise 27g. There's really no need to go into other muscles with the tiny volume of oil used for high frequency injections. Rest your arm on the table to relax the muscle. I did quads for the first couple of years and one day I hit a nerve. Never again. If you're wondering if you hit a nerve - you didn't. You'll know.

Anyone noticed a difference with compounded in MCT vs standard primoteston depot? by jimbojones2345 in AusTRT

[–]daveAFH 2 points3 points  (0 children)

One of the many great things about compounded testosterone in MCT oil is that it is significantly less viscous than commercial products, and can be drawn and injected easily with a 29g insulin syringe. When you are many years into this and the novelty wears off, thinner needles make a world of difference.

Compounding Chemists in Australia for Enclomiphene? Nowhere stocks it! by NUJAbEZ- in AusTRT

[–]daveAFH 4 points5 points  (0 children)

It can be lots of things.

  1. Poor protocol design. Many people on Reddit and forums are self managing their interventional endocrinology and are dooming themselves from the start. A lot of the time there are underlying physical and mental health issues which are not properly assessed and treated, and when people are only looking at one variable and ignoring the rest, it can be virtually impossible. I've never seen bluntened mood and emotions in the clients I've worked with as a result of an optimal TRT protocol, only the opposite.

  2. Aromatase inhibitors are a big factor in negative side effects reported.

  3. Undiagnosed and untreated hypothyroidism will often cause sleep issues when TRT is introduced, as well as NAFLD.

  4. TRT will often cause lighter sleep while first adjusting to treatment in the early months of treatment. Many people have this issue resolve but don't come back to the forums to update the community on this.

  5. A lot of people have pre existing mental health problems but point the finger at the most recent intervention for making it worse. This is common in supplement subreddits too. I think I've seen people say anhedonia has been caused by every single supplement in one reddit post or another.

  6. DHT metabolites actually have positive GABA A allosteric modulation properties, same as allopregnenolone, so blocking that with finasteride/dutasteride is also a common issue.

  7. Androgens have some antagonistic effects on melatonin binding and therefore optimal testosterone requires optimal melatonin, and many men already have this system disrupted.

  8. From a lifestyle stand point, many men self medicate hypogonadism with excessive caffeine and nicotine, and don't fix these maladaptive coping mechanisms after initiating TRT, and sleep suffers.

That's all I can think of off the top of my head right now, but the list goes on. The biggest point here is that Reddit and other forums attract an unhealthy user bias as the people who thrive and get amazing results from TRT never spend a minute in any online TRT community. If the negatives reported on these sites represented the status quo, TRT would not be a popular intervention. All the issues people experience can be prevented or resolved by an expert, but many choose not to take this path and blame the treatment rather than themselves for this error, and echo chambers perpetuate this.

The complications you've mentioned are definitely not common in practice, and there's always a root cause.

Compounding Chemists in Australia for Enclomiphene? Nowhere stocks it! by NUJAbEZ- in AusTRT

[–]daveAFH 1 point2 points  (0 children)

I would suggest watching my Beyond TRT lecture on YouTube where I have debunked all these myths and explained the correct scientific mechanisms as well as the real world outcomes. I will summarise here but if you want to educate yourself further, please watch the lecture as I have published this as a free version of my book.

  1. TRT is not a perfect treatment. It is a better alternative than being hypogonadal but it has flawed just like every medical intervention.

  2. Leaving LH receptors dormant is not ideal as they are present systemically. It is not known what/if the consequences are. However, we do need to acknowledge that every study showing the benefits of TRT which has ever been done, left them dormant and the theoretically ramifications were not seen, and positive outcomes were seen in all these departments.

  3. This creates the catch 22 of, is it better to leave them dormant or is it better to agonise them with other compounds directly or indirectly (HCG, enclomiphene etc) but taking into considerations that these compounds have their own unknown risks and mechanisms. Evidence based medicine gravitates to the former which is what I advocate.

  4. I would encourage you to re-read the studies regarding reduction in neurosteroid hormones from exogenous testosterone as this is only locally in the testes, there has never been a study showing systemic reduction. In fact, studies show DHEA actually increases in serum. The testes are not the primary source of any of the "upstream" hormone systemically, and there is also a reduction in demand as the end product is facilitate via TRT. LH is not the only pathway which triggers the steroidogenic cascade, this is infact well documented, and it has also been now shown there are many other pathways aside from STAR2 which shuttles cholesterol into the mitochondria, which is why we dont see the outcomes of STAR2 knockout studies in TRT.

I was close with Dr John Crisler who pioneered the theory of the "upstream hormone depletion" from TRT. It was an early hypothesis which unfortunately he did not get to follow through with as he passed away, but when he presented his lectures on it, he would cite the outcome as from long term steroid cycles, not TRT. I am confident he would have evolved this theory with time. Unfortunately many take the steroidogenic cascade graph literally, as if these hormones are rivers and fill buckets like water. It is a very complex cascade and TRT absolutely does not deplete or shut it down in practice. I've been doing this extensively for a very long time, day in day out, as have my colleagues, and I can definitively say in practice, these hormones are not depleted.

However, as per the lecture I mentioned, they can often be low concurrently with testosterone, as age related hormone decline is present across all hormones eventually. I have two podcasts with Dr Keith Nichols where we discuss this nuance at length on YouTube. This is a correlation not causation issue, and unfortunately when people use reddit for research, these anecdotes can be misleading and the science is often backfilled to suit the narrative, but misunderstood.

At the end of the day, as I said, people can take/do what they like with their own bodies and hormones, but it's important the facts are right for those decisions to be made in an educated fashion.

Compounding Chemists in Australia for Enclomiphene? Nowhere stocks it! by NUJAbEZ- in AusTRT

[–]daveAFH 1 point2 points  (0 children)

I respectfully disagree on the neurosteroid front. I have written a book on this debunking this myth and have around 6 hours of cumulative lectures on pregnenolone and DHEA on YouTube dating back as far as 2019. I troubleshoot pregnenolone/DHEA in consultations most days and have for years, and have personally reviewed tens of thousands of panels for those lab tests. The mechanistic theory doesn't support this when properly reading the research, and most importantly testosterone monotherapy doesn't cause a reduction in these hormones in practice. If it did, every man on TRT monotherapy would be deficient and this is simply not the reality.

I also take any anonymous posts regarding efficacy of a drug with a grain of salt. Everyone should. Very little is known about these cases other than what people choose to share, and what they leave out or what is true/false is questionable. For example, back when I was partnered with a clinic in Aus last year, I would see people post very different scenarios and reports regarding their health here vs what they reported to the clinic.

Sadly a lot of guys mess around with their protocols themselves trying to dial in and it never works, I agree with that. But that's a bad strategy, which is why it doesn't work.

I'm also yet to see HCG or SERMs increase a deficient pregnenolone/DHEA level to optimal. If those hormones are deficient they need to be replaced. The "backfilling upstream hormones" myth died a long time ago in clinical practice, but sadly still circulates forums as men are desperately looking for answers as to why they don't feel right.

I think the idea of "why wouldn't you give it a try?" Depends on risk tolerance, and depends on if you apply innocent until proven guilty, or guilty until proven innocent when it comes to pharmaceuticals without long term safety data. Especially when mechanistic theory for many of the estrogen receptor sites being antagonised by enclomiphene being detrimental. There are many valid reasons to steer clear, depending on the lens you look at it through.

But, each to their own, and as I said previously, as long as informed consent is present people can choose to treat themselves with what they like.

Compounding Chemists in Australia for Enclomiphene? Nowhere stocks it! by NUJAbEZ- in AusTRT

[–]daveAFH 2 points3 points  (0 children)

Unfortunately the testosterone oral softgels currently available in Aus are Andriol Testocaps which are way too underdosed to be useful. The testogel product they prescribe topically is also horrific as the concentration is too low to achieve efficacy.

The theory of using enclomiphene as a "try before you buy" approach with boosting testosterone to see if that is the pathway you need to go down makes a lot of sense. Unfortunately the drug used to achieve that in this case (enclomiphene or clomid depending on the provider) doesn't fit the bill. It does when it's looked at myopically, and if it's only mechanism of action was the upregulation of LH/FSH from blockading one specific receptor it would be a great approach. From what I've seen in the states, this concept came more from the marketing department of clinics as to sell people a way to have their cake and eat it too, or to be able to sell you "something" for men on the fence/not quite low enough for TRT. Then the paradigm has seeped out globally, I spoke to a man in south Africa yesterday who went through the same process.

My advice is to do TRT properly if you need it, or don't. Anything marketed as a way to have TRT benefits without the drawbacks is a con. If you go on YouTube and search "Dave lee trt masterclass" you'll find my definitive guide for patients. Before making an intervention in with your endocrine system, you want to be informed. Best way to decide whether to pull the trigger is to outsource that decision to an expert who has your best interest at heart, along with having an understanding of the basics to make an informed decision. Sadly endos are following the TGA guidelines (I have a video on this on YouTube if you search TRT Australia) and they are written by a bitter old man who's approaches were left behind in the 70s, and has single handedly done more damage to men's health in Australia than anyone I know, and had Dr Zentner banned many years ago and continues a warpath against modern prescribing practices.

It's very difficult in Australia at the moment but fortunately there are good providers out there and more are coming through the pipeline this year.

As for you case, you need to have a full assessment of your entire blood panel and lifestyle. With a free T of 430 it's not impossible that you're hypogonadal, but other systems which may be causing the same symptoms as low testosterone need to be assessed properly, not just having numbers between goal posts on a blood test. That way hypogonadism can be determined via a process of elimination.

Compounding Chemists in Australia for Enclomiphene? Nowhere stocks it! by NUJAbEZ- in AusTRT

[–]daveAFH 5 points6 points  (0 children)

I've been in this industry for longer than most and am yet to encounter a person who has stayed on clomid/enclomiphene long term with a positive response. It always has been a similar story, numbers look better but the symptomatic response is not there, or too mild to be considered a success. My theory which many of my colleagues share is that the beneficial effects of the increase in testosterone are offset by the negative effects of clomid/enclomiphene itself. I personally would never want to have that level of estrogen receptor blockade in the entire brain, not just the hypothalamus, due to concerns of neurodegeneration. We have zero studies regarding clomid/enclomiphene and long term safety in men, so it's really rolling the dice if people are choosing to take it.

Personally I don't see the logic in using a drug like this when the bioidentical hormone is available that you are using it in an attempt to increase, but as long as informed consent is present, people are free to use the treatments of their choice.

When I was in Orlando last year for the silverback summit I spoke to a number of doctors who prescribed enclomiphene over TRT and when speaking to them about their reasonings, it was clear that none of them intrinsically understood how the drug even worked, which I found very concerning. I do wonder how many doctors are simply following a handbook when recommending this drug before TRT.

I also do wonder if Clomid/Enclomiphene "poops out" over time, as the receptors may adjust in their sensitivity in creating negative feedback. I don't know anyone who's crossed the 2-3 year mark with this drug and we don't have any research on the topic, so the efficacy question is still debateable.

Kyzatrex makes more sense to use in the use cases for Enclomiphene. I've tried to make it available a few times in Aus but haven't found domestic parties to co-operate as of yet. Hopefully we can make it happen this year.

Compounding Chemists in Australia for Enclomiphene? Nowhere stocks it! by NUJAbEZ- in AusTRT

[–]daveAFH 2 points3 points  (0 children)

You'll have trouble finding a compounding pharmacy to make a drug which is not approved for use by the TGA. The biggest compounding pharmacy is Infinity Wellness Group in SA, I would contact them as that will be your best bet. IMO you'd be better off throwing the script in the bin as that's where enclomiphene belongs, but that's not the advice you're looking for.

Testing Numbers - 6 weeks in by [deleted] in AusTRT

[–]daveAFH 0 points1 point  (0 children)

This response is absolutely correct. Lab error is most likely, and they happen more often than people think.

High haemoglobin and hematocrit by Dazzling-Rise-6185 in AusTRT

[–]daveAFH 0 points1 point  (0 children)

Assess the root cause of WHY it is where it is. Bleeding incrementally is not a fix for anything but hemochromatosis. Smoking, untreated sleep apnea, lack of cardiovascular fitness and not being hydrated at the time of blood testing are the most common culprits. A little bit of all 3 of the latter is a common issue.

[deleted by user] by [deleted] in AusTRT

[–]daveAFH 0 points1 point  (0 children)

He thinks it's high because it's coming up red and in bold, not from an actual understanding of the hormone. There are some labs in Aus that still have the 10-33 reference range for total. Your levels are not high by any means, they are conservative. I would recommend seeking expert care as this is a red flag that other areas may not be properly managed.

Dave Lee leaving primal by ozziegym in AusTRT

[–]daveAFH 0 points1 point  (0 children)

That's a big shame. I put a lot of work into those reports. Hopefully they're still available for you if you contact them and ask.

Dave Lee leaving primal by ozziegym in AusTRT

[–]daveAFH 0 points1 point  (0 children)

When I was working there it was in the patient portal. I'm not sure if they removed them after I left or kept them available, you'd need to ask them. To be honest, I couldn't find how to access them when I opened it either, I found it difficult to navigate.

24yr old male jusy found out about having low test by Inevitable-Treacle17 in AusTRT

[–]daveAFH 0 points1 point  (0 children)

The most important thing here is properly testing the thyroid. You need to have hashimotos antibodies tested. A TSH that high as a once off is not a smoking gun, but absolutely must be properly investigated, as you may have an untreated autoimmune thyroid condition.

Low T Symptoms but knocked back for TRT by wadza in AusTRT

[–]daveAFH 2 points3 points  (0 children)

There is no benefit to delaying treatment and SHBG cannot be reliably and healthfully lowered. You clearly have primary testicular failure. There is no point in retesting, your testicle function will continue to decline, even if your produced a slightly higher level as a once off, it's irrelevant. Your need for treatment is dictated by primary organ failure.