Guest guest Posted August 4, 2010 Report Share Posted August 4, 2010 That's the hard part. Most guys give up on TRT because of a doc that has no idea what they are doing. I did it the hard way, by gathering all the info I could and then educating my docs. I don't reccommend this approach as most of them are hard headed and slow learners. Your absolute best bet is going to be to get to Michigan and see Dr. Crisler. He's one of the top 3 or 4 in the country and probably the best from what people tell me. It took me years to get it right, Dr can probably cut that to a matter of months. If you can't go to see Dr there's got to be a decent doc somewhere in NY. Post on the following fourms and you'll get some names. yahoo forum: hypogonadism2 allthingsmale.com this is Dr 's forum You can learn everything you need to know from these sites. When you go to allthingsmale click on " links " and then on to the forum. There is a sticky there called " TRT A Recipe for Success " , read that to get a good idea how it works. Don't just go to any doc, you will be doomed to failure. good luck , let me know how it goes Robb > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2010 Report Share Posted August 4, 2010 Hi Robb, thanks for your information about TRT. I've got my labs done last week and found that estradiol is very high (86 vs the normal 56). My doctor gave Arimidex as it lowers the conversion of T into estrogen. Did you have genital numbness as well before starting on TRT? Or was it only the libido & erection? I'm trying to see what options I need to try to see some improvement. Subject: Re: EurologistTo: SSRIsex Date: Wednesday, August 4, 2010, 2:44 PM That's the hard part. Most guys give up on TRT because of a docthat has no idea what they are doing. I did it the hard way, by gathering all the info I could and then educating my docs. I don't reccommend this approach as most of them are hard headed and slowlearners.Your absolute best bet is going to be to get to Michigan and seeDr. Crisler. He's one of the top 3 or 4 in the country andprobably the best from what people tell me. It took me years to getit right, Dr can probably cut that to a matter of months.If you can't go to see Dr there's got to be a decent docsomewhere in NY. Post on the following fourms and you'll get somenames.yahoo forum: hypogonadism2allthingsmale.com this is Dr 's forumYou can learn everything you need to know from these sites. When yougo to allthingsmale click on "links" and then on to the forum. Thereis a sticky there called "TRT A Recipe for Success " , read that toget a good idea how it works.Don't just go to any doc, you will be doomed to failure.good luck , let me know how it goesRobb> > > > >> > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2010 Report Share Posted August 4, 2010 Hey Robb, I'll look into these stat. Thanks! I'll keep you posted. All the best, -M > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2010 Report Share Posted August 5, 2010 I had all the symptoms you mention, I mean I thought about having sex with every female that walked but when it came right down to it there was no fire in the nuts. I still want to screw everything that walks but if I dwell on them too long these days I will get a embarassing erection in public. I've even done that on the tennis courts when hot girls pass by, especially the young ones, they are like magic, walking viagra. For the record my last tests a week ago T = 790 E = 23 I don't do arimidex anymore, it will take my E lower than that fast. And much lower is as bad as too high. I keep it down with zinc and DIM and by just staying pretty lean. Good luck > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2010 Report Share Posted August 5, 2010 Oh, I didn't want you to think I'm knocking Arimidex, it works well for lot of guys, they swear by it. But keep in mind if you start having severe joint pain you are taking too much. This is rare but it happened to me. It goes away when you're off Arimidex for a couple of days. It's powerful stuff, you see how small those pills are, I was using a pill cutter and taking a quarter pill every two days. hope it works for you > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2010 Report Share Posted August 5, 2010 THanks a lot Robb for your response. My doc asked me to take Arimidex at 1mg/week. So, hopefully thats not too high. And my T is 520 (I'm 33 yrs), not sure if Arimidex would do the trick or I might actually have to go on TRT. Subject: Re: EurologistTo: SSRIsex Date: Thursday, August 5, 2010, 11:38 PM I had all the symptoms you mention, I mean I thought about having sexwith every female that walked but when it came right down to it there was no fire in the nuts. I still want to screw everything that walksbut if I dwell on them too long these days I will get a embarassingerection in public. I've even done that on the tennis courts when hot girls pass by, especially the young ones, they are like magic, walkingviagra. For the record my last tests a week ago T = 790 E = 23I don't do arimidex anymore, it will take my E lower than that fast.And much lower is as bad as too high. I keep it down with zinc andDIM and by just staying pretty lean. Good luck> > > > > >> > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Oh, man, don't get a brain MRI. I had one after consulting an endocrinologist. All blood results came back normal, but out of three lab tests, one prolactin level came out just slightly high (the other 2 times prolactin and everything else was normal). The pituitary MRI turned up nothing and my insurance rejected the claim because there was really no reason to have it done. There must be a convincing lab result for your insurance to cover brain MRI. > > > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2010 Report Share Posted August 8, 2010 You are right about the free and total testosterone being in the "normal" range is no good if it's low or low-normal. I recall a few on here in the group were in their 20s with low testosterone but within the normal reference range and their doctors told them that is fine! I found this interesting info: "CORRECTING A HORMONE IMBALANCE Step 1- Blood Testing Step 2- Interpretation Blood Test Results Step 3-When Results Are Not Optimal A male hormone imbalance can be detected through use of the proper blood tests and can be corrected using available drugs and nutrients. The following represents a step-by-step program to safely restore youthful hormone balance in aging men:Step 1: Blood Testing. The following initial blood tests are recommended for any man over age 40: Complete blood count and chemistry profile to include liver-kidney function, glucose, minerals, lipids, and thyroid (TSH) Free and Total Testosterone Estradiol (estrogen) DHT (dihydrotestosterone) DHEA PSA Homocysteine Luteinizing hormone (LH) (optional) Sex Hormone Binding Globulin (SHBG) (optional) Step 2: Interpretation of Free Testosterone, Estrogen, and Total Testosterone Blood Test Results. One can easily determine if they need testosterone replacement or estrogen suppression by adhering to the following guidelines.Free Testosterone. Free testosterone blood levels should be at the high-normal of the reference range. We define high-normal range as the upper one third of the reference range. Under no circumstances should free or total testosterone be above the high end of the normal range.What too often happens is that a standard laboratory "reference range" deceives a man (and his physician) into believing that proper hormone balance exists because the results of a free testosterone test fall within the "normal" range. The following charts show a wide range of so-called "normal" ranges of testosterone for men of various ages. While these normal ranges may reflect population "averages," the objective for most men over age 40 is to be in the upper one-third testosterone range of the 21- to 29-year-old group. Based on the following reference range chart from LabCorp, this means that optimal free testosterone levels should be between 21-26.5 nanogram/dL in aging men.Reference Intervals for Free Testosterone from LabCorp 20-29 years 9.3-26.5 picogram/mL 30-39 years 8.7-25.1 picogram/mL 40-49 years 6.8-21.5 picogram/mL 50-59 years 7.2-24.0 picogram/mL 60+ years 6.6-18.1 picogram/mL An example of how this chart can be deceptive would be if a 50-year-old man presented symptoms of testosterone deficiency (depression, low energy, abdominal obesity, angina, etc.), but his blood test revealed his free testosterone to be 9 picogram/mL. His doctor might tell him he is fine because he falls within the normal "reference range." The reality may be that to achieve optimal benefits, testosterone levels should be between 21-26.5 picogram/mL. That means a man could have less than half the amount of testosterone needed to overcome symptoms of a tes-tosterone deficiency, but his doctor will not prescribe testosterone replacement because the man falls within the "average" parameters. That is why it is so important to differentiate between "average" and "optimal." Average 50-year-old men often have the symptoms of having too little testosterone. Yet since so many 50-year-old men have lower than desired testosterone levels, this is considered to be "normal" when it comes to standard laboratory reference ranges.The Life Extension Foundation would like to point out that there is disagreement between clinicians and laboratories on the best method for measuring tes-tosterone status. There are different schools of thought as to which form of testosterone should be measured and which analytical procedure provides the most accurate assessment of metabolic activity.To illistrate this point, the reference values for measuring free testosterone from Quest Diagnostics follow.Adult Male (20-60+ years): 1.0-2.7% 50-210 pg/mLOptimal Range: 150-210 pg/mL for aging men without prostate cancer.We believe that direct testing for free testosterone is the best way to test for testosterone activity, as free testosterone is active testosterone and consists of only 1-2% of total testosterone. Total testosterone can be good for general testing. The four main methods presently used for analyzing free testosterone are: Direct, Free Testosterone by Direct Analog/Radioimmunoassay (RIA) Testosterone Free by Ultrafiltration (UF) Testosterone Free by Equilibrium Tracer Dialysis (ETD) Testosterone Free and Weakly Bound by Radioasssay (FWRA) The latter three test methods are older, more complicated methods that are technically demanding. The direct RIA test has a number of commercial test kits available, and they are better used in today's automated equipment, making this test less tedious and requiring a smaller (less) sample. These advantages have convinced many laboratories and clinics to prefer direct RIA testing for free testosterone. The Life Extension Foundation agrees with this assessment, and therefore uses and recommends the direct free testosterone test with the above-mentioned reference levels.Consequently, if your doctor tests your free tes-tosterone, be sure you know the analytical method used. If your test results have a reference range as follows, you have probably been tested with one of the other test methods:Male Reference Range - Test Type 66-417 nanogram/dL FWRA 12.3-63% %FWRA 5-21 nanogram/dL UF or ETD 50-210 picogram/mL UF or ETD 1.0-2.7% % of free by UF or ETD No matter what test method is used to determine your free testosterone status, the optimal level (where you want to be) is in the upper one-third of normal for a 20-29 year old male.EstrogenEstrogen (measured as estradiol) should be in the mid- to lower-normal range. If estradiol levels are in the upper one-third of the normal reference range, or above the normal reference range, this excessive level of estrogen should be reduced. Labcorp lists a reference range of between 3-70 picogram/mL for estradiol while Quest states a reference range of between 10-50. For optimal health, estradiol should be in the range of 10-30 picogram/mL for a man of any age.The fact that most aging men have too much estrogen does not mean it is acceptable for a man to have low estrogen. Estrogen is used by men to maintain bone density, and abnormally low estrogen levels may increase the risk for prostate cancer and osteoporosis. The objective is to achieve hormone balance, not to create sky-high testosterone levels without enough estrogen. The problem is that, if we do nothing, most men will have too much estrogen and far too little testosterone.Total TestosteroneSome men have their total testosterone measured. Standard reference ranges are between 241-827 nanograms/dL for most laboratories. Many older men are below 241. Optimal levels of total testosterone for most men are between 500-827 nanograms/dL. If your levels are lower than 500 nanograms/dL or even a little higher and you still have symptoms, you should check your free testosterone by the Direct (RIA) method.For other hormone tests, the following are considered to be optimal:Where You Want to Be - CommentPSA Under 2.6 ng/mL - (optimal range) Standard reference range is up to 4, but if your level is persistently 2.6 or above, have a blood test to measure the percentage of free vs. bound PSA and a digital rectal exam to help rule out prostate cancer.DHEA 400-560 mcg/dL - (optimal range) For older men, standard DHEA ranges are very low. It is important for men without prostate cancer to restore them to the youthful range (400-560).DHT 20-50 nanogram/dL - (optimal range) Reference range is 30-85. DHT is 10 times more androgenic than testosterone and has been implicated in prostate problems and hair loss.Luteinizing hormone (LH) Age 20-70: 1.5-9.3 mIU/mL 70+: 3.1-34.6 mIU/mL (standard reference ranges) - Under 9.3 mIU/mL - (optimal range) If these levels are high, it is an indication of testicular testosterone production deficiency. LH tells the testes to produce testosterone. If there is too little testosterone present, the pituitary gland secretes more LH in a futile effort to stimulate testicular testosterone production. Testosterone replacement therapy should suppress excess LH levels. Low LH can also be a sign of estrogen overload, since too much estrogen can suppress LH activity. This could mean using an estrogen blocker like Arimidex could solve a testosterone deficiency problem.Sex Hormone Binding - Under 30 nanomoles/L - (optimal range) Reference range is 13-71 nanomole/L. Excessive binding inactivates testosterone (297).There are five possible reasons why free testosterone levels may be low-normal (below the upper third of the highest number of the reference range): Too much testosterone is being converted to estradiol by excess aromatase enzyme and/or the liver is failing to adequately detoxify surplus estrogen. Excess aromatase enzyme and/or liver dysfunction is likely the cause if estradiol levels are over 30. Remember, aromatase converts testosterone into estradiol, which can cause estrogen overload and testosterone deficiency. Too much free testosterone is being bound by SHBG (sex hormone binding globulin). This would be especially apparent if total testosterone levels were in the high normal range, while free testosterone was below the upper one-third range. The pituitary gland fails to secrete adequate amounts of luteinizing hormone (LH) to stimulate testicular production of testosterone. Total testosterone in this case would be in the bottom one-third to one-half range. (On LabCorp's scale, this would be a number below 241-500 ng/dL.) The testes have lost their ability to produce testosterone, despite adequate amounts of the testicular-stimulating luteinizing hormone. In this case, LH would be above normal, and total testosterone would in very low normal or below normal ranges. Inadequate amounts of DHEA are being produced in the body. (DHEA is a precursor hormone to tes-tosterone and estrogen) (250). Step 3: What to Do When Results Are Less Than Optimal If estradiol levels are high (above 30), total testosterone is mid- to high-normal, and free testosterone levels are low or low-normal (at the bottom one third of the highest number on the reference range), you should: Make sure you are getting 80 mg a day of zinc. (Zinc functions as an aromatase inhibitor for some men.) Consume 400 mg of indole-3-carbinol to help neutralize dangerous estrogen metabolites. Cruciferous vegetables, such as broccoli and cauliflower, can also stimulate the liver to metabolize and excrete excess estrogen. Reduce or eliminate alcohol consumption to enable your liver to better remove excess estrogens (refer to the Liver Degenerative Disease protocol to learn about ways to restore healthy liver function). Review all drugs you are regularly taking to see if they may be interfering with healthy liver function. Common drugs that affect liver function are the NSAIDs: ibuprofen, acetaminophen, aspirin, the "statin" class of cholesterol-lowering drugs, some heart and blood pressure medications, and some antidepressants. It is interesting to note that drugs being prescribed to treat the symptoms of testosterone deficiency such as the statins and certain antidepressants may actually aggravate a testosterone deficit, thus making the cholesterol problem or depression worse. Lose weight. Fat cells, especially in the abdominal region, produce the aromatase enzyme, which converts testosterone into estrogen (242). Take a combination supplement providing a flavonoid called chrysin (1000 mg) along with piperine (10 mg) to enable the chrysin to be absorbed into the blood stream. Chrysin has been shown to be a mild aromatase inhibitor. This combination of chrysin and peperine can be found in a product called Super MiraForte. If all of the above fail to increase free testosterone and lower excess estradiol, ask your doctor to prescribe the potent aromatase inhibiting drug Arimidex (anastrozole) in the very low dose of 0.5 mg twice a week. Arimidex is prescribed to breast cancer patients at the dose of 1-10 mg a day. Even at the higher dose prescribed to cancer patients, side effects are rare. In the minute dose of 0.5 mg twice a week, a man will see an immediate drop in estradiol levels and should experience a rise in free testosterone to the optimal range. If free testosterone levels are in the lower two thirds of the highest number in the reference range, but total testosterone is high-normal, and estradiol levels are not over 30, you should Consider following some of the recommendations in the previous section to inhibit aromatase because many of the same factors are involved in excess SHBG activity. Take 320 mg a day of the super-critical extract of saw palmetto and 240 mg a day of the methanolic extract of nettle (Urtica dioica). Nettle may specifically inhibit SHGB (42-44, 251, 252), while saw palmetto may reduce the effects of excess estrogen by blocking the nuclear estrogen receptor sites in prostate cells, which in turn activate the cell-stimulating effects of testosterone and dihydrotes-tosterone. Saw palmetto also has the effect of blocking the oxidation of testosterone to androstenedione, a potent androgen that has been implicated in the development of prostate disease (253). If total testosterone is in the lower third of the reference range or below normal, and free testosterone is low, and estradiol levels are under 30, you should Initiate therapy with the testosterone patch, pellet, or cream. Do not use testosterone injections or tablets. or See if your luteinizing hormone (LH) is below normal. If LH is low, your doctor can prescribe an individual dose of chorionic gonadotropin (HCG) hormone for injection. Chorionic gonadotropic hormone functions similarly to LH and can re-start testicular production of testosterone. Your doctor can instruct you about how to use tiny 30-gauge needles to give yourself injections 2-3 times a week.After 1 month on chorionic gonadotropic hormone, a blood test can determine whether total testosterone levels are significantly increasing. You may also see your testicles growing larger.Before initiating testosterone replacement therapy, have a PSA blood test and a digital rectal exam to rule out detectable prostate cancer. Once total testosterone levels are restored to a high-normal range, monitor blood levels of estradiol, free testosterone, and PSA every 30-45 days for the first 6 months to make sure the exogenous testosterone you are using is following a healthy metabolic pathway and not causing a flare-up of an underlying prostate cancer. The objective is to raise your levels of free testosterone to the upper third of the reference range, but to not increase estradiol levels beyond 30.Excess estrogen (estradiol) blocks the production and effect of testosterone throughout the body, dampens sexuality, and increases the risk of prostate and cardiovascular disease. Once you have established the proper ratio of free testosterone (upper third of the highest number in the reference range) and estradiol (not more than 30), make sure your blood is tested every 30-45 days for the first 5 months. Test every 6 months thereafter for free testosterone, estradiol, and PSA. For men in their 40s-50s, correcting the excess level of estradiol is often all that has to be done.THERAPIES"Andro" SupplementsAndrostenedione is a precursor to both testosterone and estrogen. Early studies showed that "andro" supplements could markedly increase testosterone levels, but more recent studies cast doubt on this concept. A study in the Journal of the American Medical Association (1999) reported on an 8-week study showing that androstenedione supplements increased estrogen levels in 30 men (258). No increase in strength, muscle mass, or testosterone levels was observed. Perhaps combining androstenedione with an aromatase inhibitor that would prevent it from converting to estrogen would make this precursor hormone work better in men. In the meantime, we suggest avoiding androstenedione until more definitive research is published.Testosterone Patches, Creams, Pellets, and TabletsSynthetic testosterone "steroid" drugs are chemically different from the testosterone your body makes and do not provide the same effect as natural testosterone. Some of the synthetic testosterone drugs to avoid using on a long-term basis are methyltestosterone, danazol, oxandrolone, testosterone propionate, cypionate, or enanthate.The fact that testosterone is marketed as a "drug" does not mean it is not the same natural hormone your body produced. Scientists learned decades ago how to make the identical testosterone that your body produces, but since natural testosterone could not be patented, drug companies developed all kinds of synthetic testosterone analogs that could be patented and approved by the FDA as new drugs. Currently available recommended natural testosterone drugs are: Androderm Transdermal System (Kline Beecham's testosterone patch) Testoderm Transdermal System (Alza's testosterone patch) Testosterone creams, pellets, and sublingual tablets (available from compounding pharmacies) Both synthetic and natural testosterone drugs require a prescription, and a prescription should only be written after blood or saliva tests reveal a testosterone deficiency.Alternative physicians usually prescribe testosterone creams and other types made at compounding pharmacies, whereas conventional doctors are more likely to prescribe a box of ready-made, FDA-approved testosterone patches. All forms of natural testosterone are the same and all will markedly increase free testosterone in the blood or saliva.If you interact with children, you may want to avoid testosterone creams. There is a report of a young male child going through premature puberty after the child made contact with the testosterone cream on his father's body and on weightlifting equipment in the home. This unique case is a testament to the powerful effects that testosterone exerts in the body.Caution: Do not use testosterone replacement if you have prostate cancer.Men with existing prostate cancer should follow an opposite approach as it relates to testosterone. Prostate cancer patients are normally prescribed testosterone ablation therapy (using a drug that blocks the pituitary release of LH and another drug that blocks testosterone-receptor sites on the cells). Early-stage prostate cancer cells can often be controlled by totally suppressing testosterone in the body. Late-stage prostate cancer patients are sometimes put on drugs that produce estrogenic effects to suppress prostate cancer cells that no longer depend on testosterone for growth. Regrettably, prostate cancer patients on tes-tosterone ablation therapy often temporarily have many of the unpleasant effects of low testosterone that have been described in this article. Before initiating a therapy that boosts your free testosterone level, a blood PSA test and digital rectal exam are recommended for men over age 40. While restoring free testosterone to healthy physiological levels does not cause prostate cancer, it can induce existing prostate cancer cells to proliferate faster.Natural Testosterone-Boosting/Estrogen-Suppressing ApproachesChrysin. A bioflavonoid called chrysin has shown potential as a natural aromatase-inhibitor. Chrysin can be extracted from various plants. Bodybuilders have used it as a testosterone-boosting supplement because by inhibiting the aromatase enzyme, less testosterone is converted into estrogen. The problem with chrysin is that because of its poor absorption into the bloodstream, it has not produced the testosterone-enhancing effects users expect.In a study published in Biochemical Pharmacology (1999), the specific mechanisms of chrysin's absorption impairment were identified, which infers that the addition of a pepper extract (piperine) could significantly enhance the bioavailability of chrysin (304). Pilot studies have found that when chrysin is combined with piperine, reductions in serum estrogen (estradiol) and increases in total and free testosterone result in 30 days. Aromatase-inhibiting drugs are used to treat women with estrogen-dependent breast cancers. The rationale for this therapy is that estrogen is produced by fat cells via a process known as aromatization. Aging men often have excess aromatase enzyme activity, and the result is that too much of their testosterone is "aromatized" into estrogen.In a study published in the Journal of Steroid Biochemical Molecular Biology (1993), chrysin and 10 other flavonoids were compared to an aromatase-inhibiting drug (aminoglutethimide) (298). The study tested the aromatase-inhibiting effects of these natural flavonoids (such as genistein, rutin, tea catechins, etc.) in human fat cell cultures. Chrysin was the most potent aromatase-inhibitor, and was shown to be similar in potency and effectiveness to the aromatase-inhibiting drug. The scientists conducting the study concluded by stating that the aromatase-inhibiting effects of certain flavonoids may contribute to the cancer preventive effects of plant-based diets.Two studies have identified specific mechanisms by which chrysin inhibits aromatase in human cells. These studies demonstrate that chrysin is a more potent inhibitor of the aromatase enzyme than phytoestrogens and other flavonoids that are known to have aromatase-inhibiting properties (299, 300). The purpose of these studies was to ascertain which fruits and vegetables should be included in the diet of postmenopausal women to reduce the incidence of breast cancer. Excess levels of mutagenic forms of estrogen have been linked to a greater risk of breast cancer, and scientists are studying dietary means of naturally reducing levels of these dangerous estrogens. Flavonoids such as chrysin are of considerable interest because they suppress excess estrogen via their aromatase-inhibiting properties. Although this cancer preventing effect is most important for women, inhibiting aromatase in aging men has tremendous potential for naturally suppressing excess estrogen while boosting low levels of testosterone to a youthful state.Since chrysin is not a patentable drug, do not expect to see a lot of human research documenting its effects. There are many FDA-approved drugs that inhibit aromatase (such as Arimidex), and there is not much economic interest in finding natural ways of replacing these drugs. Although prescription aromatase-inhibiting drugs are relatively free of side effects, aging men who are seeking to gain control over their sex hormone levels sometimes prefer natural sources, rather than trying to convince a physician to prescribe a drug (such as Arimidex) that is not yet approved by the FDA as an antiaging therapy. (Arimidex is prescribed to estrogen-dependant breast cancer patients to prevent testosterone and other hormones in the body from converting, i.e., aromatasing, into estrogen.)An advantage to using plant extracts to boost testosterone in lieu of drugs is that the plant extracts have ancillary health benefits. Chrysin, for example, is a potent antioxidant that produces vitamin-like effects in the body. It has been shown to induce an anti-inflammatory effect, possibly through inhibition of the enzymes 5-lipooxygenase and cyclooxygenase inflammation pathways. Aging is being increasingly viewed as a proinflammatory process, and agents that inhibit chronic inflammation may protect against diseases as diverse as atherosclerosis, senility, and aortic valve stenosis. Chrysin is one of many flavonoids being studied as a phyto-extract that may prevent some forms of cancer. If chrysin can boost free testosterone in the aging male by inhibiting the aromatase enzyme, this would provide men with a low-cost natural supplement that could provide the dual antiaging benefits of tes-tosterone replacement and aromatase-inhibiting drug therapy. Pilot studies indicate that chrysin increases total and free testosterone levels in the majority of men who take it with piperine.Chrysin has one other property that could add to its libido-enhancing potential. A major cause of sexual dissatisfaction among men is work-related stress and anxiety. Another problem some men have is "sexual performance anxiety" that prevents them from being able to achieve erections when they are expected to. In a study published in Pharmacology Biochemistry and Behavior (1994), mice were injected with diazepam (Valium), chrysin, or placebo to evaluate the effects these substances had on anxiety and performance levels. Chrysin was shown to produce antianxiety effects comparable with diazepam, but without sedation and muscle relaxation. In other words, chrysin produced a relaxing effect in the brain, but with no impairment of motor activity. The mechanism of action of chrysin was compared to diazepam, and it was shown that unlike diazepam, chrysin can reduce anxiety without inducing the common side effects associated with benzodiazepine drugs.A common problem with benzodiazepine drugs is memory impairment. In a study published in Pharmacology Biochemistry and Behavior (1997), chrysin displayed potent antianxiety effects in rats, but did not interfere with cognitive performance. In this study, diazepam was shown to inhibit neurological function, but chrysin (and other antianxiety flavonoids) had no effect on training or test session performance. The scientists conducting this study pointed out that chrysin selectively inhibits anxiety in the brain but, unlike diazepam, does not induce the cognitive impairment (302).Chrysin may therefore offer libido-enhancing effects in the aging male by Increasing free testosterone Decreasing excess estrogen Producing a safe antianxiety effect Chrysin is being sold to bodybuilders by commercial supplement companies that do not know if their product is favorably modulating testosterone and estrogen levels in men. The Life Extension Foundation, on the other hand, has conducted studies to evaluate the effects of chrysin (combined with piperine to facilitate absorption) on aging men.Nettle. About 90% of testosterone is produced by the testes; the remainder is produced by the adrenal glands. Tes-tosterone functions as an aphrodisiac hormone in brain cells and as an anabolic hormone in the development of bone and skeletal muscle. But testosterone that becomes bound to serum globulin is not available to cell receptor sites and fails to induce a libido effect. It is therefore desirable to increase levels of "free tes-tosterone" in order to ignite sexual arousal in the brain.As discussed already, a hormone that controls levels of free testosterone is called SHBG. When testosterone binds to SHBG, it loses its biological activity and becomes known as "bound testosterone," as opposed to the desirable "free testosterone." As men age past age 45, SHBG's binding capacity increases almost dramatically--by 40% on average--and coincides with the age-associated loss of libido.Some studies show that the decline in sexual interest with advancing age is not always due to the amount of testosterone produced, but rather to the increased binding of testosterone to globulin by SHBG. This explains why some older men who are on testosterone replacement therapy do not report a long-term aphrodisiac effect. That is, the artificially administered testosterone becomes bound by SHBG and is not bioavailable to cellular receptor sites where it would normally produce a libido-enhancing effect.It should be noted that the liver also causes tes-tosterone to bind to globulin. This liver-induced binding of testosterone is worsened by the use of sedatives, antihypertensives, tranquilizers, and alcoholic beverages. The overuse of drugs and alcohol could explain why some men do not experience a libido-enhancing effect when consuming drugs and plant-based aphrodisiacs. An interesting review entitled "How Desire Dies" (Nature, 381/6584, 1996) discusses how frequently prescribed drugs, such as beta-blockers and antidepressants, cause sexual dysfunction. Prescription drugs of all types have been linked to inhibition of libido.Logically, one way of increasing libido in older men would be to block the testosterone-binding effects of SHBG. This would leave more testosterone in its free, sexually activating form.A highly concentrated extract from the nettle root provides a unique mechanism for increasing levels of free testosterone. European research has identified constituents of nettle root that bind to SHBG in place of testosterone, thus reducing SHBG's binding of free testosterone (309-313). As the authors of one study stated, these constituents of nettle root "may influence the blood level of free, i.e., active, steroid hormones by displacing them from the SHBG binding site."The prostate gland also benefits from nettle root. In Germany, nettle root has been used as a treatment for benign prostatic hyperplasia (enlargement of the prostate gland) for decades. A metabolite of testosterone called dihydrotestosterone (DHT) stimulates prostate growth, leading to enlargement. Nettle root inhibits the binding of DHT to attachment sites on the prostate membrane.Nettle extracts also inhibit enzymes such as 5-alpha reductase that cause testosterone to convert to DHT. It is the DHT metabolite of testosterone that is known to cause benign prostate enlargement, excess facial hair, and hair loss at the top of the head." http://www.lifeextensionvitamins.com/mahomothpa2.html > > > > > >> > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2010 Report Share Posted August 8, 2010 Hi Robb, A lot of men with PSSD wake up some mornings (or most mornings) without an erection. From what you know and read on forums, do you know if this is an indication that free testosterone levels need to be higher (but not more than the high reference point)? I no longer buy the doctors' view that so long as free and total testosterone is " within the normal reference range " then total and free testosterone is fine. Did Dr Crisler improve or cure your PSSD? Thanks. > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2010 Report Share Posted August 8, 2010 Has anyone tried tongkat ali for testosterone? I was reading online (wikipedia) that MIT has tested the supplement and even holds a patent on it. Apparently in the correct formulation it might help with testosterone. I am one of those guys in his 20's with T levels of an 80 year old but I really do not want to go on T replacement due to the side effects. Ever since SSRI's I am very nervous about side effects. > > > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It > ended up being a huge waste of time. Since my blood test results showed > that my testosterone was at a normal level and I didn't have any kidney > issues, thyroid etc., he could not tell me where or how my erectile > dysfunction was happening and gave me some cialis and said to come back > in 4 months. I guess since I am not showing and physical problems that > link me to erectile dysfunction, there is nothing they can do. I was > extremely disappointed. Now I'm thinking I should look into seeing a > neurologist, because I have a feeling that a scan of my brain is the > only way to show that my PSSD exists. Maybe then I can get some answers. > Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2010 Report Share Posted August 8, 2010 Thanks for posting this below. Can someone clarify for me, I got lost in the "What to do when results are less than optimal" where it talks about nettle and saw palmeto. Are those to be taken for low T and high E as was Chrysin or were they recommended for another inbalance. The outline is confusing as to the wording just before it discusses nettle/saw pameto.Thanks if anyone can clarify this.BillTo: SSRIsex From: csln223@...Date: Sun, 8 Aug 2010 12:33:29 +0000Subject: Re: Eurologist You are right about the free and total testosterone being in the "normal" range is no good if it's low or low-normal. I recall a few on here in the group were in their 20s with low testosterone but within the normal reference range and their doctors told them that is fine! I found this interesting info: "CORRECTING A HORMONE IMBALANCE Step 1- Blood Testing Step 2- Interpretation Blood Test Results Step 3-When Results Are Not Optimal A male hormone imbalance can be detected through use of the proper blood tests and can be corrected using available drugs and nutrients. The following represents a step-by-step program to safely restore youthful hormone balance in aging men:Step 1: Blood Testing. The following initial blood tests are recommended for any man over age 40: Complete blood count and chemistry profile to include liver-kidney function, glucose, minerals, lipids, and thyroid (TSH) Free and Total Testosterone Estradiol (estrogen) DHT (dihydrotestosterone) DHEA PSA Homocysteine Luteinizing hormone (LH) (optional) Sex Hormone Binding Globulin (SHBG) (optional) Step 2: Interpretation of Free Testosterone, Estrogen, and Total Testosterone Blood Test Results. One can easily determine if they need testosterone replacement or estrogen suppression by adhering to the following guidelines.Free Testosterone. Free testosterone blood levels should be at the high-normal of the reference range. We define high-normal range as the upper one third of the reference range. Under no circumstances should free or total testosterone be above the high end of the normal range.What too often happens is that a standard laboratory "reference range" deceives a man (and his physician) into believing that proper hormone balance exists because the results of a free testosterone test fall within the "normal" range. The following charts show a wide range of so-called "normal" ranges of testosterone for men of various ages. While these normal ranges may reflect population "averages," the objective for most men over age 40 is to be in the upper one-third testosterone range of the 21- to 29-year-old group. Based on the following reference range chart from LabCorp, this means that optimal free testosterone levels should be between 21-26.5 nanogram/dL in aging men.Reference Intervals for Free Testosterone from LabCorp 20-29 years 9.3-26.5 picogram/mL 30-39 years 8.7-25.1 picogram/mL 40-49 years 6.8-21.5 picogram/mL 50-59 years 7.2-24.0 picogram/mL 60+ years 6.6-18.1 picogram/mL An example of how this chart can be deceptive would be if a 50-year-old man presented symptoms of testosterone deficiency (depression, low energy, abdominal obesity, angina, etc.), but his blood test revealed his free testosterone to be 9 picogram/mL. His doctor might tell him he is fine because he falls within the normal "reference range." The reality may be that to achieve optimal benefits, testosterone levels should be between 21-26.5 picogram/mL. That means a man could have less than half the amount of testosterone needed to overcome symptoms of a tes-tosterone deficiency, but his doctor will not prescribe testosterone replacement because the man falls within the "average" parameters. That is why it is so important to differentiate between "average" and "optimal." Average 50-year-old men often have the symptoms of having too little testosterone. Yet since so many 50-year-old men have lower than desired testosterone levels, this is considered to be "normal" when it comes to standard laboratory reference ranges.The Life Extension Foundation would like to point out that there is disagreement between clinicians and laboratories on the best method for measuring tes-tosterone status. There are different schools of thought as to which form of testosterone should be measured and which analytical procedure provides the most accurate assessment of metabolic activity.To illistrate this point, the reference values for measuring free testosterone from Quest Diagnostics follow.Adult Male (20-60+ years): 1.0-2.7% 50-210 pg/mLOptimal Range: 150-210 pg/mL for aging men without prostate cancer.We believe that direct testing for free testosterone is the best way to test for testosterone activity, as free testosterone is active testosterone and consists of only 1-2% of total testosterone. Total testosterone can be good for general testing. The four main methods presently used for analyzing free testosterone are: Direct, Free Testosterone by Direct Analog/Radioimmunoassay (RIA) Testosterone Free by Ultrafiltration (UF) Testosterone Free by Equilibrium Tracer Dialysis (ETD) Testosterone Free and Weakly Bound by Radioasssay (FWRA) The latter three test methods are older, more complicated methods that are technically demanding. The direct RIA test has a number of commercial test kits available, and they are better used in today's automated equipment, making this test less tedious and requiring a smaller (less) sample. These advantages have convinced many laboratories and clinics to prefer direct RIA testing for free testosterone. The Life Extension Foundation agrees with this assessment, and therefore uses and recommends the direct free testosterone test with the above-mentioned reference levels.Consequently, if your doctor tests your free tes-tosterone, be sure you know the analytical method used. If your test results have a reference range as follows, you have probably been tested with one of the other test methods:Male Reference Range - Test Type 66-417 nanogram/dL FWRA 12.3-63% %FWRA 5-21 nanogram/dL UF or ETD 50-210 picogram/mL UF or ETD 1.0-2.7% % of free by UF or ETD No matter what test method is used to determine your free testosterone status, the optimal level (where you want to be) is in the upper one-third of normal for a 20-29 year old male.EstrogenEstrogen (measured as estradiol) should be in the mid- to lower-normal range. If estradiol levels are in the upper one-third of the normal reference range, or above the normal reference range, this excessive level of estrogen should be reduced. Labcorp lists a reference range of between 3-70 picogram/mL for estradiol while Quest states a reference range of between 10-50. For optimal health, estradiol should be in the range of 10-30 picogram/mL for a man of any age.The fact that most aging men have too much estrogen does not mean it is acceptable for a man to have low estrogen. Estrogen is used by men to maintain bone density, and abnormally low estrogen levels may increase the risk for prostate cancer and osteoporosis. The objective is to achieve hormone balance, not to create sky-high testosterone levels without enough estrogen. The problem is that, if we do nothing, most men will have too much estrogen and far too little testosterone.Total TestosteroneSome men have their total testosterone measured. Standard reference ranges are between 241-827 nanograms/dL for most laboratories. Many older men are below 241. Optimal levels of total testosterone for most men are between 500-827 nanograms/dL. If your levels are lower than 500 nanograms/dL or even a little higher and you still have symptoms, you should check your free testosterone by the Direct (RIA) method.For other hormone tests, the following are considered to be optimal:Where You Want to Be - CommentPSA Under 2.6 ng/mL - (optimal range) Standard reference range is up to 4, but if your level is persistently 2.6 or above, have a blood test to measure the percentage of free vs. bound PSA and a digital rectal exam to help rule out prostate cancer.DHEA 400-560 mcg/dL - (optimal range) For older men, standard DHEA ranges are very low. It is important for men without prostate cancer to restore them to the youthful range (400-560).DHT 20-50 nanogram/dL - (optimal range) Reference range is 30-85. DHT is 10 times more androgenic than testosterone and has been implicated in prostate problems and hair loss.Luteinizing hormone (LH) Age 20-70: 1.5-9.3 mIU/mL 70+: 3.1-34.6 mIU/mL (standard reference ranges) - Under 9.3 mIU/mL - (optimal range) If these levels are high, it is an indication of testicular testosterone production deficiency. LH tells the testes to produce testosterone. If there is too little testosterone present, the pituitary gland secretes more LH in a futile effort to stimulate testicular testosterone production. Testosterone replacement therapy should suppress excess LH levels. Low LH can also be a sign of estrogen overload, since too much estrogen can suppress LH activity. This could mean using an estrogen blocker like Arimidex could solve a testosterone deficiency problem.Sex Hormone Binding - Under 30 nanomoles/L - (optimal range) Reference range is 13-71 nanomole/L. Excessive binding inactivates testosterone (297).There are five possible reasons why free testosterone levels may be low-normal (below the upper third of the highest number of the reference range): Too much testosterone is being converted to estradiol by excess aromatase enzyme and/or the liver is failing to adequately detoxify surplus estrogen. Excess aromatase enzyme and/or liver dysfunction is likely the cause if estradiol levels are over 30. Remember, aromatase converts testosterone into estradiol, which can cause estrogen overload and testosterone deficiency. Too much free testosterone is being bound by SHBG (sex hormone binding globulin). This would be especially apparent if total testosterone levels were in the high normal range, while free testosterone was below the upper one-third range. The pituitary gland fails to secrete adequate amounts of luteinizing hormone (LH) to stimulate testicular production of testosterone. Total testosterone in this case would be in the bottom one-third to one-half range. (On LabCorp's scale, this would be a number below 241-500 ng/dL.) The testes have lost their ability to produce testosterone, despite adequate amounts of the testicular-stimulating luteinizing hormone. In this case, LH would be above normal, and total testosterone would in very low normal or below normal ranges. Inadequate amounts of DHEA are being produced in the body. (DHEA is a precursor hormone to tes-tosterone and estrogen) (250). Step 3: What to Do When Results Are Less Than Optimal If estradiol levels are high (above 30), total testosterone is mid- to high-normal, and free testosterone levels are low or low-normal (at the bottom one third of the highest number on the reference range), you should: Make sure you are getting 80 mg a day of zinc. (Zinc functions as an aromatase inhibitor for some men.) Consume 400 mg of indole-3-carbinol to help neutralize dangerous estrogen metabolites. Cruciferous vegetables, such as broccoli and cauliflower, can also stimulate the liver to metabolize and excrete excess estrogen. Reduce or eliminate alcohol consumption to enable your liver to better remove excess estrogens (refer to the Liver Degenerative Disease protocol to learn about ways to restore healthy liver function). Review all drugs you are regularly taking to see if they may be interfering with healthy liver function. Common drugs that affect liver function are the NSAIDs: ibuprofen, acetaminophen, aspirin, the "statin" class of cholesterol-lowering drugs, some heart and blood pressure medications, and some antidepressants. It is interesting to note that drugs being prescribed to treat the symptoms of testosterone deficiency such as the statins and certain antidepressants may actually aggravate a testosterone deficit, thus making the cholesterol problem or depression worse. Lose weight. Fat cells, especially in the abdominal region, produce the aromatase enzyme, which converts testosterone into estrogen (242). Take a combination supplement providing a flavonoid called chrysin (1000 mg) along with piperine (10 mg) to enable the chrysin to be absorbed into the blood stream. Chrysin has been shown to be a mild aromatase inhibitor. This combination of chrysin and peperine can be found in a product called Super MiraForte. If all of the above fail to increase free testosterone and lower excess estradiol, ask your doctor to prescribe the potent aromatase inhibiting drug Arimidex (anastrozole) in the very low dose of 0.5 mg twice a week. Arimidex is prescribed to breast cancer patients at the dose of 1-10 mg a day. Even at the higher dose prescribed to cancer patients, side effects are rare. In the minute dose of 0.5 mg twice a week, a man will see an immediate drop in estradiol levels and should experience a rise in free testosterone to the optimal range. If free testosterone levels are in the lower two thirds of the highest number in the reference range, but total testosterone is high-normal, and estradiol levels are not over 30, you should Consider following some of the recommendations in the previous section to inhibit aromatase because many of the same factors are involved in excess SHBG activity. Take 320 mg a day of the super-critical extract of saw palmetto and 240 mg a day of the methanolic extract of nettle (Urtica dioica). Nettle may specifically inhibit SHGB (42-44, 251, 252), while saw palmetto may reduce the effects of excess estrogen by blocking the nuclear estrogen receptor sites in prostate cells, which in turn activate the cell-stimulating effects of testosterone and dihydrotes-tosterone. Saw palmetto also has the effect of blocking the oxidation of testosterone to androstenedione, a potent androgen that has been implicated in the development of prostate disease (253). If total testosterone is in the lower third of the reference range or below normal, and free testosterone is low, and estradiol levels are under 30, you should Initiate therapy with the testosterone patch, pellet, or cream. Do not use testosterone injections or tablets. or See if your luteinizing hormone (LH) is below normal. If LH is low, your doctor can prescribe an individual dose of chorionic gonadotropin (HCG) hormone for injection. Chorionic gonadotropic hormone functions similarly to LH and can re-start testicular production of testosterone. Your doctor can instruct you about how to use tiny 30-gauge needles to give yourself injections 2-3 times a week.After 1 month on chorionic gonadotropic hormone, a blood test can determine whether total testosterone levels are significantly increasing. You may also see your testicles growing larger.Before initiating testosterone replacement therapy, have a PSA blood test and a digital rectal exam to rule out detectable prostate cancer. Once total testosterone levels are restored to a high-normal range, monitor blood levels of estradiol, free testosterone, and PSA every 30-45 days for the first 6 months to make sure the exogenous testosterone you are using is following a healthy metabolic pathway and not causing a flare-up of an underlying prostate cancer. The objective is to raise your levels of free testosterone to the upper third of the reference range, but to not increase estradiol levels beyond 30.Excess estrogen (estradiol) blocks the production and effect of testosterone throughout the body, dampens sexuality, and increases the risk of prostate and cardiovascular disease. Once you have established the proper ratio of free testosterone (upper third of the highest number in the reference range) and estradiol (not more than 30), make sure your blood is tested every 30-45 days for the first 5 months. Test every 6 months thereafter for free testosterone, estradiol, and PSA. For men in their 40s-50s, correcting the excess level of estradiol is often all that has to be done.THERAPIES"Andro" SupplementsAndrostenedione is a precursor to both testosterone and estrogen. Early studies showed that "andro" supplements could markedly increase testosterone levels, but more recent studies cast doubt on this concept. A study in the Journal of the American Medical Association (1999) reported on an 8-week study showing that androstenedione supplements increased estrogen levels in 30 men (258). No increase in strength, muscle mass, or testosterone levels was observed. Perhaps combining androstenedione with an aromatase inhibitor that would prevent it from converting to estrogen would make this precursor hormone work better in men. In the meantime, we suggest avoiding androstenedione until more definitive research is published.Testosterone Patches, Creams, Pellets, and TabletsSynthetic testosterone "steroid" drugs are chemically different from the testosterone your body makes and do not provide the same effect as natural testosterone. Some of the synthetic testosterone drugs to avoid using on a long-term basis are methyltestosterone, danazol, oxandrolone, testosterone propionate, cypionate, or enanthate.The fact that testosterone is marketed as a "drug" does not mean it is not the same natural hormone your body produced. Scientists learned decades ago how to make the identical testosterone that your body produces, but since natural testosterone could not be patented, drug companies developed all kinds of synthetic testosterone analogs that could be patented and approved by the FDA as new drugs. Currently available recommended natural testosterone drugs are: Androderm Transdermal System (Kline Beecham's testosterone patch) Testoderm Transdermal System (Alza's testosterone patch) Testosterone creams, pellets, and sublingual tablets (available from compounding pharmacies) Both synthetic and natural testosterone drugs require a prescription, and a prescription should only be written after blood or saliva tests reveal a testosterone deficiency.Alternative physicians usually prescribe testosterone creams and other types made at compounding pharmacies, whereas conventional doctors are more likely to prescribe a box of ready-made, FDA-approved testosterone patches. All forms of natural testosterone are the same and all will markedly increase free testosterone in the blood or saliva.If you interact with children, you may want to avoid testosterone creams. There is a report of a young male child going through premature puberty after the child made contact with the testosterone cream on his father's body and on weightlifting equipment in the home. This unique case is a testament to the powerful effects that testosterone exerts in the body.Caution: Do not use testosterone replacement if you have prostate cancer.Men with existing prostate cancer should follow an opposite approach as it relates to testosterone. Prostate cancer patients are normally prescribed testosterone ablation therapy (using a drug that blocks the pituitary release of LH and another drug that blocks testosterone-receptor sites on the cells). Early-stage prostate cancer cells can often be controlled by totally suppressing testosterone in the body. Late-stage prostate cancer patients are sometimes put on drugs that produce estrogenic effects to suppress prostate cancer cells that no longer depend on testosterone for growth. Regrettably, prostate cancer patients on tes-tosterone ablation therapy often temporarily have many of the unpleasant effects of low testosterone that have been described in this article. Before initiating a therapy that boosts your free testosterone level, a blood PSA test and digital rectal exam are recommended for men over age 40. While restoring free testosterone to healthy physiological levels does not cause prostate cancer, it can induce existing prostate cancer cells to proliferate faster.Natural Testosterone-Boosting/Estrogen-Suppressing ApproachesChrysin. A bioflavonoid called chrysin has shown potential as a natural aromatase-inhibitor. Chrysin can be extracted from various plants. Bodybuilders have used it as a testosterone-boosting supplement because by inhibiting the aromatase enzyme, less testosterone is converted into estrogen. The problem with chrysin is that because of its poor absorption into the bloodstream, it has not produced the testosterone-enhancing effects users expect.In a study published in Biochemical Pharmacology (1999), the specific mechanisms of chrysin's absorption impairment were identified, which infers that the addition of a pepper extract (piperine) could significantly enhance the bioavailability of chrysin (304). Pilot studies have found that when chrysin is combined with piperine, reductions in serum estrogen (estradiol) and increases in total and free testosterone result in 30 days. Aromatase-inhibiting drugs are used to treat women with estrogen-dependent breast cancers. The rationale for this therapy is that estrogen is produced by fat cells via a process known as aromatization. Aging men often have excess aromatase enzyme activity, and the result is that too much of their testosterone is "aromatized" into estrogen.In a study published in the Journal of Steroid Biochemical Molecular Biology (1993), chrysin and 10 other flavonoids were compared to an aromatase-inhibiting drug (aminoglutethimide) (298). The study tested the aromatase-inhibiting effects of these natural flavonoids (such as genistein, rutin, tea catechins, etc.) in human fat cell cultures. Chrysin was the most potent aromatase-inhibitor, and was shown to be similar in potency and effectiveness to the aromatase-inhibiting drug. The scientists conducting the study concluded by stating that the aromatase-inhibiting effects of certain flavonoids may contribute to the cancer preventive effects of plant-based diets.Two studies have identified specific mechanisms by which chrysin inhibits aromatase in human cells. These studies demonstrate that chrysin is a more potent inhibitor of the aromatase enzyme than phytoestrogens and other flavonoids that are known to have aromatase-inhibiting properties (299, 300). The purpose of these studies was to ascertain which fruits and vegetables should be included in the diet of postmenopausal women to reduce the incidence of breast cancer. Excess levels of mutagenic forms of estrogen have been linked to a greater risk of breast cancer, and scientists are studying dietary means of naturally reducing levels of these dangerous estrogens. Flavonoids such as chrysin are of considerable interest because they suppress excess estrogen via their aromatase-inhibiting properties. Although this cancer preventing effect is most important for women, inhibiting aromatase in aging men has tremendous potential for naturally suppressing excess estrogen while boosting low levels of testosterone to a youthful state.Since chrysin is not a patentable drug, do not expect to see a lot of human research documenting its effects. There are many FDA-approved drugs that inhibit aromatase (such as Arimidex), and there is not much economic interest in finding natural ways of replacing these drugs. Although prescription aromatase-inhibiting drugs are relatively free of side effects, aging men who are seeking to gain control over their sex hormone levels sometimes prefer natural sources, rather than trying to convince a physician to prescribe a drug (such as Arimidex) that is not yet approved by the FDA as an antiaging therapy. (Arimidex is prescribed to estrogen-dependant breast cancer patients to prevent testosterone and other hormones in the body from converting, i.e., aromatasing, into estrogen.)An advantage to using plant extracts to boost testosterone in lieu of drugs is that the plant extracts have ancillary health benefits. Chrysin, for example, is a potent antioxidant that produces vitamin-like effects in the body. It has been shown to induce an anti-inflammatory effect, possibly through inhibition of the enzymes 5-lipooxygenase and cyclooxygenase inflammation pathways. Aging is being increasingly viewed as a proinflammatory process, and agents that inhibit chronic inflammation may protect against diseases as diverse as atherosclerosis, senility, and aortic valve stenosis. Chrysin is one of many flavonoids being studied as a phyto-extract that may prevent some forms of cancer. If chrysin can boost free testosterone in the aging male by inhibiting the aromatase enzyme, this would provide men with a low-cost natural supplement that could provide the dual antiaging benefits of tes-tosterone replacement and aromatase-inhibiting drug therapy. Pilot studies indicate that chrysin increases total and free testosterone levels in the majority of men who take it with piperine.Chrysin has one other property that could add to its libido-enhancing potential. A major cause of sexual dissatisfaction among men is work-related stress and anxiety. Another problem some men have is "sexual performance anxiety" that prevents them from being able to achieve erections when they are expected to. In a study published in Pharmacology Biochemistry and Behavior (1994), mice were injected with diazepam (Valium), chrysin, or placebo to evaluate the effects these substances had on anxiety and performance levels. Chrysin was shown to produce antianxiety effects comparable with diazepam, but without sedation and muscle relaxation. In other words, chrysin produced a relaxing effect in the brain, but with no impairment of motor activity. The mechanism of action of chrysin was compared to diazepam, and it was shown that unlike diazepam, chrysin can reduce anxiety without inducing the common side effects associated with benzodiazepine drugs.A common problem with benzodiazepine drugs is memory impairment. In a study published in Pharmacology Biochemistry and Behavior (1997), chrysin displayed potent antianxiety effects in rats, but did not interfere with cognitive performance. In this study, diazepam was shown to inhibit neurological function, but chrysin (and other antianxiety flavonoids) had no effect on training or test session performance. The scientists conducting this study pointed out that chrysin selectively inhibits anxiety in the brain but, unlike diazepam, does not induce the cognitive impairment (302).Chrysin may therefore offer libido-enhancing effects in the aging male by Increasing free testosterone Decreasing excess estrogen Producing a safe antianxiety effect Chrysin is being sold to bodybuilders by commercial supplement companies that do not know if their product is favorably modulating testosterone and estrogen levels in men. The Life Extension Foundation, on the other hand, has conducted studies to evaluate the effects of chrysin (combined with piperine to facilitate absorption) on aging men.Nettle. About 90% of testosterone is produced by the testes; the remainder is produced by the adrenal glands. Tes-tosterone functions as an aphrodisiac hormone in brain cells and as an anabolic hormone in the development of bone and skeletal muscle. But testosterone that becomes bound to serum globulin is not available to cell receptor sites and fails to induce a libido effect. It is therefore desirable to increase levels of "free tes-tosterone" in order to ignite sexual arousal in the brain.As discussed already, a hormone that controls levels of free testosterone is called SHBG. When testosterone binds to SHBG, it loses its biological activity and becomes known as "bound testosterone," as opposed to the desirable "free testosterone." As men age past age 45, SHBG's binding capacity increases almost dramatically--by 40% on average--and coincides with the age-associated loss of libido.Some studies show that the decline in sexual interest with advancing age is not always due to the amount of testosterone produced, but rather to the increased binding of testosterone to globulin by SHBG. This explains why some older men who are on testosterone replacement therapy do not report a long-term aphrodisiac effect. That is, the artificially administered testosterone becomes bound by SHBG and is not bioavailable to cellular receptor sites where it would normally produce a libido-enhancing effect.It should be noted that the liver also causes tes-tosterone to bind to globulin. This liver-induced binding of testosterone is worsened by the use of sedatives, antihypertensives, tranquilizers, and alcoholic beverages. The overuse of drugs and alcohol could explain why some men do not experience a libido-enhancing effect when consuming drugs and plant-based aphrodisiacs. An interesting review entitled "How Desire Dies" (Nature, 381/6584, 1996) discusses how frequently prescribed drugs, such as beta-blockers and antidepressants, cause sexual dysfunction. Prescription drugs of all types have been linked to inhibition of libido.Logically, one way of increasing libido in older men would be to block the testosterone-binding effects of SHBG. This would leave more testosterone in its free, sexually activating form.A highly concentrated extract from the nettle root provides a unique mechanism for increasing levels of free testosterone. European research has identified constituents of nettle root that bind to SHBG in place of testosterone, thus reducing SHBG's binding of free testosterone (309-313). As the authors of one study stated, these constituents of nettle root "may influence the blood level of free, i.e., active, steroid hormones by displacing them from the SHBG binding site."The prostate gland also benefits from nettle root. In Germany, nettle root has been used as a treatment for benign prostatic hyperplasia (enlargement of the prostate gland) for decades. A metabolite of testosterone called dihydrotestosterone (DHT) stimulates prostate growth, leading to enlargement. Nettle root inhibits the binding of DHT to attachment sites on the prostate membrane.Nettle extracts also inhibit enzymes such as 5-alpha reductase that cause testosterone to convert to DHT. It is the DHT metabolite of testosterone that is known to cause benign prostate enlargement, excess facial hair, and hair loss at the top of the head." http://www.lifeextensionvitamins.com/mahomothpa2.html > > > > > >> > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 8, 2010 Report Share Posted August 8, 2010 Here's a website with some good info on testosterone, estrogen, SHBG, etc. http://www.peaktestosterone.com/Hdr_Testosterone.aspx "Testosterone Levels - Male Probably the most common questions I get are: 1) Are my testosterone levels normal for a male? 2) What should male testosterone levels be? Well, normal is relative as we all know. But, even so, we can come up with some solid guidelines that will help you know where you stand. However, I first want to encourage you to throw out the completely lame and utterly useless "normal" range that your doctor or lab technician will give you. A typical normal male testosterone level range given is 260 -1080 ng/dl as (which corresponds to about 8.8 - 36.7 nmol/l). Well, to that I can only say that you can call any level you want normal, but 260 is nothing but ugly. In fact 300 and 350 are ugly testosterone levels for a male. Virtually every email that I get where a guy is struggling is from some guy with total testosterone under 400 ng/dl. And younger guys, again based on numerous emails that I have received, struggle with testosterone less than 500. I have never received any email from someone complaining with testosterone levels over 500. So the normal testosterone pain threshold is about 500, depending on a male's age and history. (Below 400 is almost always a free pass to hormonal hell.) That is why I am so disgusted with the medical profession when they tell one of my fellow male brothers that a total testosterone level of 290 is fine and normal. (Please read my link on Testosterone Symptoms if you do not know how dangerous low testosterone levels are to your health.) Now let's jump to some important points when comparing your numbers to these kind of average or "normal" male testosterone levels. First of all, you must remember not to panic if your testosterone is a little below what is given above. For example, there are many guys with testosterone in the 400's that are doing great with solid libido, erections and heart health. In fact, guys like this probably have no idea that their testosterone is below "normal" and are doing just fine. Although let me jump in and say that many young guys have written in that are struggling with testosterone levels in the 400's as I mentioned. Young males seem to be particularly sensitive or perhaps it's the relative value compared to age that really counts. Regardless, I have known several younger guys who have reported dramatically improved erections and libido when given supplemental testosterone even though they were in the 400's and were supposely "normal". http://www.peaktestosterone.com/Testosterone_Levels_Male.aspx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 9, 2010 Report Share Posted August 9, 2010 In some men depression is due to their testosterone levels - not their serotonin levels! Depression May Be Related to Testosterone Levels in Men: Presented at CPA By Marvin RossTORONTO, CANADA -- November 13, 2006 -- Untreated depressed middle aged men may exhibit hypothalamic-pituitary-gonadal axis hypofunctioning as indicated by the presence of low bioavailable testosterone (BT) levels according to a poster presented by Dr. McIntyre at the 56th Annual Conference of the Canadian Psychiatric Association (CPA) meeting here.Dr. McIntyre is an Associate Professor of Psychiatry and Pharmacology at the University of Toronto and Head of the Mood Disorders Psychopharmacology Unit at the University Health Network, Toronto, Ontario, Canada.Total testosterone (TT) levels are known to decline linearly with age and it is estimated that a significant proportion of men over 30 are hypogonadal. This decline in TT produces a set of symptoms that are similar to a major depressive episode characterized by fatigue, irritability, dysphoria and loss of libido. It is therefore conceivable that testosterone may play a role in depression.BT is the bioactive fraction of circulating TT that is not tightly bound to SHGB and is considered to more accurately reflect the clinical androgen status of the individual. Consequently, it was hypothesized that calculated BT levels would be significantly lower among depressed untreated middle aged men than among a matched non depressed control group.The study compared 44 depressed men aged 40 to 65 years with a mean score of 20.8 on the 17-question Hamilton Rating Scale for Depression (HAM-D 17) and 50 controls with a mean HAM-D 17 score of 0.1. All subjects were in good health and had a body mass index of BMI of 20 to 29.For the study, the researchers collected overnight fasting blood sample between 8 and 11 in the morning. Psychometric measures used were Diagnostic and Statistical Manual Fourth Edition, Text Revision and a HAM-D-17 total score greater than 16 and the second version of the Beck Depression Inventory.Biochemical hypogonadism was defined as bioavailable testosterone (BT) no greater than 2.4 nmol/L and total testosterone (TT) no greater than 12.14 nmol/L.Levels of TT were 11.94 among patients with major depression and 17.64 among healthy controls (P < .001). Bioavailable testosterone measures were 3.51 among patients with depression and 4.69 among controls (P = .008). The proportions of subjects with BT-defined hypogonadism were 34% and 6%, respectively (P < .001). Using TT as an indicator of hypogonadism, the differences were even more pronounced -- 61.4% and 14%, respectively (P < .001).Men with depression have a significantly lower BT level than do non-depressed men but using TT as the threshold to define hypogonadism revealed an even greater difference between the 2 groups in this study, according to the researchers. This suggests use of TT may overestimate the number of men who have hypogonadism. Nonetheless, the results do suggest that depression may be related to testosterone levels in men.[Presentation title: Calculated Bioavailable Testosterone Levels and Depression in Middle Aged Men. Poster P22] http://www.docguide.com/news/content.nsf/news/852571020057CCF68525722500722B59 Effects of testosterone supplementation on depressive symptoms and sexual dysfunction in hypogonadal men with the metabolic syndrome: the Moscow Study Conclusions: Testosterone Undecanoate (TU) administration may improve depressive symptoms, aging male symptoms and sexual dysfunction in hypogonadal men with the MetS. The beneficial effects of testosterone were most prominent in men with the lowest baseline total testosterone levels. http://www.endocrine-abstracts.org/ea/0022/ea0022p524.htm Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 9, 2010 Report Share Posted August 9, 2010 Some interesting info I found: " One of the best indicators of Free Testosterone levels is frequency of morning erections since there are no psychological or stimulative factors involved. It's strictly a biological response and governed by one's health. Most young men experience this daily. Once a guy gets into his 40's, that pleasant morning surprise may not rear its head as often. (Pun intended). Regardless of what age you are, if you wake up more than two days in a row without an erection, or if it's weak or becomes flaccid within a minute of being awake, it's a safe bet to say your free Testosterone is down. " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 9, 2010 Report Share Posted August 9, 2010 Did you get your all-important Free testosterone checked too? It's important you got your Estradiol checked because a lot of doctors don't think of doing a blood test for it. "We touched on aromatase, the enzyme that converts Free Testosterone into estrogen. A lot of men have done the above and still get no results, and their doctors are giving the patients testosterone injections. This is why many doctors feel that testosterone does nothing for a man other than temporarily, then he resorts back to his former self. But what the doctor failed to do and realize is that the aromatase enzyme is the culprit here, in addition to SHBG. He will never figure it out unless he runs an Estradiol or estrogen blood test, as well as a SHBG test too. Most doctors don't do this, but if they did, they'd find the patient's estrogen before he started testosterone might be, for instance, 20 ng/dL, and after a month on testosterone therapy, the Estradiol level might be something like 60 ng/dL, a tripling! It's no wonder the patient failed to improve in his libido, his muscle building, or his get-up-and-go, other than for the first two weeks." > > > > > > >> > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > > > > > > > >> > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 9, 2010 Report Share Posted August 9, 2010 SSRIs sre associated with an increased risk of diabetes: http://www.naturalnews.com/019875.html > > > > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 9, 2010 Report Share Posted August 9, 2010 Unfortunately, I did not get that checked. My doc basically knows shit and I had to tell him exactly what I wanted tested. I'll ask him for that. Thank you.. Subject: Re: EurologistTo: SSRIsex Date: Monday, August 9, 2010, 11:55 PM Did you get your all-important Free testosterone checked too? It's important you got your Estradiol checked because a lot of doctors don't think of doing a blood test for it. "We touched on aromatase, the enzyme that converts Free Testosterone into estrogen. A lot of men have done the above and still get no results, and their doctors are giving the patients testosterone injections. This is why many doctors feel that testosterone does nothing for a man other than temporarily, then he resorts back to his former self. But what the doctor failed to do and realize is that the aromatase enzyme is the culprit here, in addition to SHBG. He will never figure it out unless he runs an Estradiol or estrogen blood test, as well as a SHBG test too. Most doctors don't do this, but if they did, they'd find the patient's estrogen before he started testosterone might be, for instance, 20 ng/dL, and after a month on testosterone therapy, the Estradiol level might be something like 60 ng/dL, a tripling! It's no wonder the patient failed to improve in his libido, his muscle building, or his get-up-and-go, other than for the first two weeks." > > > > > > >> > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > > > > > > > >> > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 10, 2010 Report Share Posted August 10, 2010 Yeah it's difficult to find a doc or endo who knows what they are doing regarding the hormone levels. This link has some good info regarding hormones which a lot of GPs won't know about. http://www.chemicalbiological.net/natural%20supplements%20 & %20muscle%20building.html I'm glad I've now learnt that "within the normal reference range" is garbage and what we need is an endo who treats the symptoms and doesn't think PSSD symptoms are psychological just because testosterone is "within the normal reference range". Next time I'm not going to mention SSRIs to the doctor/endo because once they hear we took an SSRI then they usually think our problem is "psychological" or we are suffering from depression (even though I've never had depression). Interestingly, I've read that many men with depression have at least 20% reduction in testosterone levels, which is likely cause of their low libido. Dr Crisler's excellent forum recommended by Robb where we can all learn alot (Dr Crisler is one of the top endos in the U.S.). http://musclechatroom.com/forum/forumdisplay.php?f=2 > > > > > > > >> > > > > > > > Well I finally got to go in to see the eurologist today. It ended up being a huge waste of time. Since my blood test results showed that my testosterone was at a normal level and I didn't have any kidney issues, thyroid etc., he could not tell me where or how my erectile dysfunction was happening and gave me some cialis and said to come back in 4 months. I guess since I am not showing and physical problems that link me to erectile dysfunction, there is nothing they can do. I was extremely disappointed. Now I'm thinking I should look into seeing a neurologist, because I have a feeling that a scan of my brain is the only way to show that my PSSD exists. Maybe then I can get some answers. Do you think this should be my next plan of action?> > > > > > > > > > > > > > > > > > > > > > > >> > > > > > >> > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2010 Report Share Posted August 16, 2010 Sorry, I've been on vacation, almost didn't catch this. Yes, since we can't run to the doc for blood tests every week the presence or absense of and quality of morning erections is THE primary indicator of the state of homonal balance in men. It may well indicate low total T and or low free T. For men already on TRT with good total and free T (measured by blood test) the morning erection is primarily an indicator of high or low estradiol. This is what we use to either increase or decrease anit-aromatase measures and stay in the " sweet spot " . I have never been to see Dr.Chisler , but I have read everyting he's written and that is the basis for my treatment. Cure? no. I would only consider it a cure if I were on NO meds and functioning perfectly. Compared to before treatment however the difference is like night and day. Erections are seldom ever a problem, and at times pleasure rivals the best you can remember. At other times you fall out of range and it's good but not as good and you know it's just a matter of days before you get " zoned " again. ALL sex is better than the decade I wasted before treatment. And it appears to be getting better: Two weeks ago I changed my protocol from 250u HCG every third day to 150u every other day based on based on things I've read on Dr 's fourm and other places. This seems to be the current thinking, some guys are even doing everyday. I have to report the improvement is dramatic. Morning erections are down-right scary and general horniness is almost out of control. Wife is not complaining ! Robb -- - In SSRIsex , " csln223 " wrote: > > > Hi Robb, > > A lot of men with PSSD wake up some mornings (or most mornings) without > an erection. From what you know and read on forums, do you know if this > is an indication that free testosterone levels need to be higher (but > not more than the high reference point)? I no longer buy the doctors' > view that so long as free and total testosterone is " within the normal > reference range " then total and free testosterone is fine. > > Did Dr Crisler improve or cure your PSSD? > > Thanks. > > > > > > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It > ended up being a huge waste of time. Since my blood test results showed > that my testosterone was at a normal level and I didn't have any kidney > issues, thyroid etc., he could not tell me where or how my erectile > dysfunction was happening and gave me some cialis and said to come back > in 4 months. I guess since I am not showing and physical problems that > link me to erectile dysfunction, there is nothing they can do. I was > extremely disappointed. Now I'm thinking I should look into seeing a > neurologist, because I have a feeling that a scan of my brain is the > only way to show that my PSSD exists. Maybe then I can get some answers. > Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2010 Report Share Posted August 16, 2010 Does anyone know of any doctors in Canada, in the Brantford area, Toronto to Windsor area. How much does Dr. Chilser charge for a visit, I know that Canadian health care will not take care of American doctors, but will Dr. Chilser see Canadians?DaleTo: SSRIsex Sent: Mon, August 16, 2010 11:11:48 AMSubject: Re: Eurologist Sorry, I've been on vacation, almost didn't catch this. Yes, since we can't run to the doc for blood tests every week the presence or absense of and quality of morning erections is THE primary indicator of the state of homonal balance in men. It may well indicate low total T and or low free T. For men already on TRT with good total and free T (measured by blood test) the morning erection is primarily an indicator of high or low estradiol. This is what we use to either increase or decrease anit-aromatase measures and stay in the " sweet spot". I have never been to see Dr.Chisler , but I have read everyting he's written and that is the basis for my treatment. Cure? no. I would only consider it a cure if I were on NO meds and functioning perfectly. Compared to before treatment however the difference is like night and day. Erections are seldom ever a problem, and at times pleasure rivals the best you can remember. At other times you fall out of range and it's good but not as good and you know it's just a matter of days before you get "zoned" again. ALL sex is better than the decade I wasted before treatment. And it appears to be getting better: Two weeks ago I changed my protocol from 250u HCG every third day to 150u every other day based on based on things I've read on Dr 's fourm and other places. This seems to be the current thinking, some guys are even doing everyday. I have to report the improvement is dramatic. Morning erections are down-right scary and general horniness is almost out of control. Wife is not complaining ! Robb -- - In SSRIsex , "csln223" wrote: > > > Hi Robb, > > A lot of men with PSSD wake up some mornings (or most mornings) without > an erection. From what you know and read on forums, do you know if this > is an indication that free testosterone levels need to be higher (but > not more than the high reference point)? I no longer buy the doctors' > view that so long as free and total testosterone is "within the normal > reference range" then total and free testosterone is fine. > > Did Dr Crisler improve or cure your PSSD? > > Thanks. > > > > > > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It > ended up being a huge waste of time. Since my blood test results showed > that my testosterone was at a normal level and I didn't have any kidney > issues, thyroid etc., he could not tell me where or how my erectile > dysfunction was happening and gave me some cialis and said to come back > in 4 months. I guess since I am not showing and physical problems that > link me to erectile dysfunction, there is nothing they can do. I was > extremely disappointed. Now I'm thinking I should look into seeing a > neurologist, because I have a feeling that a scan of my brain is the > only way to show that my PSSD exists. Maybe then I can get some answers. > Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2010 Report Share Posted August 16, 2010 If you go to a sex clinic in your area or to Dr Crisler in Michigan, here is the advice from the FAQ in the Database of the group: What should I do if currently suffer SSRI sexual side effects, but have been off the drug for several months? Find a doctor and get a comprehensive blood test. We recommend the following:Total Testosterone, Bioavailable Testosterone (sometimes called "Free and Loosely Bound"), Free Testosterone (If Bio T is not available), SHBG, DHT, Estradiol (Specify the "Sensitive Extraction Method"), Total Estrogens, LH, FSH, Prolactin, Cortisol, Thyroid Panel (TSH, FT3, FT4), Complete Blood Count, Comprehensive Metabolic Panel, Lipid Panel, Homocysteine, and IGF-1 > > > > > > > >> > > > > > > > Well I finally got to go in to see the eurologist today. It> > ended up being a huge waste of time. Since my blood test results showed> > that my testosterone was at a normal level and I didn't have any kidney> > issues, thyroid etc., he could not tell me where or how my erectile> > dysfunction was happening and gave me some cialis and said to come back> > in 4 months. I guess since I am not showing and physical problems that> > link me to erectile dysfunction, there is nothing they can do. I was> > extremely disappointed. Now I'm thinking I should look into seeing a> > neurologist, because I have a feeling that a scan of my brain is the> > only way to show that my PSSD exists. Maybe then I can get some answers.> > Do you think this should be my next plan of action?> > > > > > > >> > > > > > > > > > > > > > > >> > > > > > >> > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2010 Report Share Posted August 16, 2010 I know he does work with other docs over the phone on a consulting basis. And its Crisler, I can't spell for shit. > > > > > > > > > > > > > > > > Well I finally got to go in to see the eurologist today. It > > ended up being a huge waste of time. Since my blood test results showed > > that my testosterone was at a normal level and I didn't have any kidney > > issues, thyroid etc., he could not tell me where or how my erectile > > dysfunction was happening and gave me some cialis and said to come back > > in 4 months. I guess since I am not showing and physical problems that > > link me to erectile dysfunction, there is nothing they can do. I was > > extremely disappointed. Now I'm thinking I should look into seeing a > > neurologist, because I have a feeling that a scan of my brain is the > > only way to show that my PSSD exists. Maybe then I can get some answers. > > Do you think this should be my next plan of action? > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 16, 2010 Report Share Posted August 16, 2010 Dr Crisler's website: http://www.allthingsmale.com/consultations.html http://www.allthingsmale.com/contact.html > > > > > > > >> > > > > > > > Well I finally got to go in to see the eurologist today. It> > ended up being a huge waste of time. Since my blood test results showed> > that my testosterone was at a normal level and I didn't have any kidney> > issues, thyroid etc., he could not tell me where or how my erectile> > dysfunction was happening and gave me some cialis and said to come back> > in 4 months. I guess since I am not showing and physical problems that> > link me to erectile dysfunction, there is nothing they can do. I was> > extremely disappointed. Now I'm thinking I should look into seeing a> > neurologist, because I have a feeling that a scan of my brain is the> > only way to show that my PSSD exists. Maybe then I can get some answers.> > Do you think this should be my next plan of action?> > > > > > > >> > > > > > > > > > > > > > > >> > > > > > >> > > > > >> > > > >> > > >> > >> >> Quote Link to comment Share on other sites More sharing options...
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