Re: my SHBG results i now have

October 3, 2006

What is your level of free T? Having high level of SHBG is not good, and

reduces your free Testosterone. Please share what is your total T and free

T. In my case, this is root cause of low T.

-Steve

On 10/2/06, paul wey <promachief@...> wrote:

>

> ok following on from last weeks figures

>

> total t 7.4 nmo/l range 6-27

> lh 3 iu/l range 1-9

> fsg 2 iu/l range 1-19

>

> the free testosteron level still cant be found at my doctor but the SHBG

> has now come back as

>

> 19 nmo/l range 15-55

>

> of course my doc had put on the computer " telll mr wey its normal ranbge

> and print off for him "

>

> well range at 15 nmo/l and me only 19!!!

>

> again as the other figures suggest to me that may all be in there range

> ,but even so just about it for a man of 40 is not good enough,to say again

> normal is not eright imo

>

> looking at a table given by someone on this group at age 40 my shbg should

> be around the 40 nmo/l range and some of 70 should be around the 19 nmo/l i

> have

>

> does anyone hear disagree with what i beleive is hypogonaidsm secondary??

>

> next step is to get mioney asap to get a private diagnosis and not rely on

> our health serrvice in uk that is not knoklwedhgable on the current

> testosterone issues prevalent and seem to be many years behind the real

> information out there by proffesionals who really do have this area as there

> main job.

>

> if my free testosterone i see at some point sooon will put on here but am

> i reading my shbg correctly ??

>

> am i right to say this is also low,what in effect does it being at 19 nmo/

> indicate does it indicate other things could be an issue ?

>

> as usual advice welcome

>

> regards paul

>

October 3, 2006

i thought low shbg was indicative of hypogonadism secondary and to me 19 nmo/l

on a range 15-55 is on low side so its def not high shbg

as stated as yet i have not seen the free t,only the full t which is 7.4 nmo/l

regards paul

so i am def not high shbg low yes/low normal ok but to clarrify 19 nmo// ios not

high

Re: my SHBG results i now have

What is your level of free T? Having high level of SHBG is not good, and

reduces your free Testosterone. Please share what is your total T and free

T. In my case, this is root cause of low T.

-Steve

On 10/2/06, paul wey <promachief (DOT) co.uk> wrote:

>

> ok following on from last weeks figures

>

> total t 7.4 nmo/l range 6-27

> lh 3 iu/l range 1-9

> fsg 2 iu/l range 1-19

>

> the free testosteron level still cant be found at my doctor but the SHBG

> has now come back as

>

> 19 nmo/l range 15-55

>

> of course my doc had put on the computer " telll mr wey its normal ranbge

> and print off for him "

>

> well range at 15 nmo/l and me only 19!!!

>

> again as the other figures suggest to me that may all be in there range

> ,but even so just about it for a man of 40 is not good enough,to say again

> normal is not eright imo

>

> looking at a table given by someone on this group at age 40 my shbg should

> be around the 40 nmo/l range and some of 70 should be around the 19 nmo/l i

> have

>

> does anyone hear disagree with what i beleive is hypogonaidsm secondary??

>

> next step is to get mioney asap to get a private diagnosis and not rely on

> our health serrvice in uk that is not knoklwedhgable on the current

> testosterone issues prevalent and seem to be many years behind the real

> information out there by proffesionals who really do have this area as there

> main job.

>

> if my free testosterone i see at some point sooon will put on here but am

> i reading my shbg correctly ??

>

> am i right to say this is also low,what in effect does it being at 19 nmo/

> indicate does it indicate other things could be an issue ?

>

> as usual advice welcome

>

> regards paul

>

October 4, 2006

Hi

Oh, no: It is important you get to understand this. What determines Primary

or Secondary are the Pituitary Hormones LH and FHS. If you check back I

explained this and gave you both examples.

If the LH and FSH (Pituitary Hormones) are very high and above normal at the

same time that Total T is low then this is Primary Hypogonadism.

If the LH and FSH (Pituitary Hormones) are normal, low or below normal range

then this is probably Secondary Hypogonadism.

SHBG - Sex Hormone Binding Globuline is the measure of how Testosterone

binds to proteins. This indicates the amount of Testosterone that MIGHT be

available. When patients have the same Total Testosterone levels they can

still have different available levels of Testosterone and one reason can be

indicated by the SHBG level.

How this helps.

Whilst writing I just wanted to say I have heard from the Lister Hospital

and I wkill copy you. I have written back as the Director of Pathology has

responded and I have a few more questions.

Have a good day!

Re: my SHBG results i now have

>

> What is your level of free T? Having high level of SHBG is not good, and

> reduces your free Testosterone. Please share what is your total T and free

> T. In my case, this is root cause of low T.

>

> -Steve

>

> On 10/2/06, paul wey <promachief (DOT) co.uk> wrote:

>>

>> ok following on from last weeks figures

>>

>> total t 7.4 nmo/l range 6-27

>> lh 3 iu/l range 1-9

>> fsg 2 iu/l range 1-19

>>

>> the free testosteron level still cant be found at my doctor but the SHBG

>> has now come back as

>>

>> 19 nmo/l range 15-55

>>

>> of course my doc had put on the computer " telll mr wey its normal ranbge

>> and print off for him "

>>

>> well range at 15 nmo/l and me only 19!!!

>>

>> again as the other figures suggest to me that may all be in there range

>> ,but even so just about it for a man of 40 is not good enough,to say

>> again

>> normal is not eright imo

>>

>> looking at a table given by someone on this group at age 40 my shbg

>> should

>> be around the 40 nmo/l range and some of 70 should be around the 19 nmo/l

>> i

>> have

>>

>> does anyone hear disagree with what i beleive is hypogonaidsm secondary??

>>

>> next step is to get mioney asap to get a private diagnosis and not rely

>> on

>> our health serrvice in uk that is not knoklwedhgable on the current

>> testosterone issues prevalent and seem to be many years behind the real

>> information out there by proffesionals who really do have this area as

>> there

>> main job.

>>

>> if my free testosterone i see at some point sooon will put on here but am

>> i reading my shbg correctly ??

>>

>> am i right to say this is also low,what in effect does it being at 19

>> nmo/

>> indicate does it indicate other things could be an issue ?

>>

>> as usual advice welcome

>>

>> regards paul

>>

>

October 4, 2006

this is good your SHBG is on the low side this means your Free T will be

good. 7.4 T is low what are your Dr.'s going to do about this.

Phil

paul wey <promachief@...> wrote:

i thought low shbg was indicative of hypogonadism secondary and to me

19 nmo/l on a range 15-55 is on low side so its def not high shbg

as stated as yet i have not seen the free t,only the full t which is 7.4 nmo/l

regards paul

so i am def not high shbg low yes/low normal ok but to clarrify 19 nmo// ios not

high

Re: my SHBG results i now have

What is your level of free T? Having high level of SHBG is not good, and

reduces your free Testosterone. Please share what is your total T and free

T. In my case, this is root cause of low T.

-Steve

On 10/2/06, paul wey <promachief (DOT) co.uk> wrote:

>

> ok following on from last weeks figures

>

> total t 7.4 nmo/l range 6-27

> lh 3 iu/l range 1-9

> fsg 2 iu/l range 1-19

>

> the free testosteron level still cant be found at my doctor but the SHBG

> has now come back as

>

> 19 nmo/l range 15-55

>

> of course my doc had put on the computer " telll mr wey its normal ranbge

> and print off for him "

>

> well range at 15 nmo/l and me only 19!!!

>

> again as the other figures suggest to me that may all be in there range

> ,but even so just about it for a man of 40 is not good enough,to say again

> normal is not eright imo

>

> looking at a table given by someone on this group at age 40 my shbg should

> be around the 40 nmo/l range and some of 70 should be around the 19 nmo/l i

> have

>

> does anyone hear disagree with what i beleive is hypogonaidsm secondary??

>

> next step is to get mioney asap to get a private diagnosis and not rely on

> our health serrvice in uk that is not knoklwedhgable on the current

> testosterone issues prevalent and seem to be many years behind the real

> information out there by proffesionals who really do have this area as there

> main job.

>

> if my free testosterone i see at some point sooon will put on here but am

> i reading my shbg correctly ??

>

> am i right to say this is also low,what in effect does it being at 19 nmo/

> indicate does it indicate other things could be an issue ?

>

> as usual advice welcome

>

> regards paul

>

October 4, 2006

as usual totally confused here

so my shbg at 19 nmo/l arwe you saying that is good?

surely then my 7.4 nmo/l is not low after all and i have been ok all along with

my figures after all?

doctors are not doing anything,this is purely blood tests.

at some time i do want to get the hypogonadism seciondary diagnosis and not just

paritial androgen deficiency but now i will surely be wasting my money going

private as if the prvate doc sees my shbg he too will say " no problems " and then

i would of spent money for no reason

again i am not instending to have testosterone,as testosteron will boost

pssibly my sexual functioning and i simply do not want any sexual functiuoning

thats not the problem i want or need dealing with its low energy/motivation and

so on ,and for that i am preferring to start on meds for my ADHD and should

after seeing a specialist today starrt on concerta in next week or two,he has

given me the go ahead despite my high blood pressure but my bp meds have

levelled that out a bit as well anyway.

it was my own phyicatrist who was blocking the concerta trial i shiuld of

started 3 months ago.

anyway can you tell me what my actual figures mean as its all beyond me

how come my shbg is low[and thats good you say] yet my lh/fsh and total t

suggest hypogonadsom two,yet my shbg suggests yet again its not

regards paul

Re: my SHBG results i now have

What is your level of free T? Having high level of SHBG is not good, and

reduces your free Testosterone. Please share what is your total T and free

T. In my case, this is root cause of low T.

-Steve

On 10/2/06, paul wey <promachief@ . co.uk> wrote:

>

> ok following on from last weeks figures

>

> total t 7.4 nmo/l range 6-27

> lh 3 iu/l range 1-9

> fsg 2 iu/l range 1-19

>

> the free testosteron level still cant be found at my doctor but the SHBG

> has now come back as

>

> 19 nmo/l range 15-55

>

> of course my doc had put on the computer " telll mr wey its normal ranbge

> and print off for him "

>

> well range at 15 nmo/l and me only 19!!!

>

> again as the other figures suggest to me that may all be in there range

> ,but even so just about it for a man of 40 is not good enough,to say again

> normal is not eright imo

>

> looking at a table given by someone on this group at age 40 my shbg should

> be around the 40 nmo/l range and some of 70 should be around the 19 nmo/l i

> have

>

> does anyone hear disagree with what i beleive is hypogonaidsm secondary??

>

> next step is to get mioney asap to get a private diagnosis and not rely on

> our health serrvice in uk that is not knoklwedhgable on the current

> testosterone issues prevalent and seem to be many years behind the real

> information out there by proffesionals who really do have this area as there

> main job.

>

> if my free testosterone i see at some point sooon will put on here but am

> i reading my shbg correctly ??

>

> am i right to say this is also low,what in effect does it being at 19 nmo/

> indicate does it indicate other things could be an issue ?

>

> as usual advice welcome

>

> regards paul

>

October 5, 2006

Here is what Dr. nco says about SHBG.

" The body regulates free testosterone by the production of SHBG. Higher SHBG

reduces free testosterone. SHBG is reduced by testosterone and other androgens,

insulin, and growth hormone. SHBG is increased by estrogens, thyroid hormone,

and progesterone. The balance of these factors determines the total SHBG

production. Testosterone can also be destroyed more quickly if liver enzymes for

it are stimulated in activity - such as in some drugs which induce certain liver

enzymes.

Free testosterone, however, is not that great an indicator of testosterone's

function. One can have normal or high free testosterone and still have multiple

problems associated with low testosterone levels and other hormone imbalances.

Total testosterone is better to gauge testosterone's level. If it is too low or

too high, problems can occur. If it is at a good level, then other hormone or

neurotransmitter imbalances may be present to cause the problems.

__________________

Any statement I make on this site is for educational purposes only and will

change as medical knowledge progresses. It does not constitute medical advice,

does not substitute for proper medical evaluation from physician, does not

create a doctor/patient relationship or liability. If you would like medical

advice, please make an appointment. Thank you. "

Your Total T of 7.4 nmo/l is = to 213ng/ml the range here in the US is like

230 to 870 approx. Now if your LH and FSH are also low then your Secondary it's

that smiple. You need to be on TRT your levels are low enough to cause bone

loss joint and muscles to break down. All kinds of problems are going to

happen as you get older.

This is a link to The Endocrine Society's Clinical Guidelines on Testosterone

Therapy in Adult Men with Androgen Deficiency Syndromes:

An Endocrine Society Clinical Practice Guideline. For 2006 print it as read

it and give it to your Endo.

http://tinyurl.com/oz9mm

Phil

paul wey <promachief@...> wrote: as usual totally confused here

so my shbg at 19 nmo/l arwe you saying that is good?

surely then my 7.4 nmo/l is not low after all and i have been ok all along with

my figures after all?

doctors are not doing anything,this is purely blood tests.

at some time i do want to get the hypogonadism seciondary diagnosis and not just

paritial androgen deficiency but now i will surely be wasting my money going

private as if the prvate doc sees my shbg he too will say " no problems " and then

i would of spent money for no reason

again i am not instending to have testosterone,as testosteron will boost pssibly

my sexual functioning and i simply do not want any sexual functiuoning thats not

the problem i want or need dealing with its low energy/motivation and so on ,and

for that i am preferring to start on meds for my ADHD and should after seeing a

specialist today starrt on concerta in next week or two,he has given me the go

ahead despite my high blood pressure but my bp meds have levelled that out a bit

as well anyway.

it was my own phyicatrist who was blocking the concerta trial i shiuld of

started 3 months ago.

anyway can you tell me what my actual figures mean as its all beyond me

how come my shbg is low[and thats good you say] yet my lh/fsh and total t

suggest hypogonadsom two,yet my shbg suggests yet again its not

regards paul

Re: my SHBG results i now have

What is your level of free T? Having high level of SHBG is not good, and

reduces your free Testosterone. Please share what is your total T and free

T. In my case, this is root cause of low T.

-Steve

On 10/2/06, paul wey

wrote:

>

> ok following on from last weeks figures

>

> total t 7.4 nmo/l range 6-27

> lh 3 iu/l range 1-9

> fsg 2 iu/l range 1-19

>

> the free testosteron level still cant be found at my doctor but the SHBG

> has now come back as

>

> 19 nmo/l range 15-55

>

> of course my doc had put on the computer " telll mr wey its normal ranbge

> and print off for him "

>

> well range at 15 nmo/l and me only 19!!!

>

> again as the other figures suggest to me that may all be in there range

> ,but even so just about it for a man of 40 is not good enough,to say again

> normal is not eright imo

>

> looking at a table given by someone on this group at age 40 my shbg should

> be around the 40 nmo/l range and some of 70 should be around the 19 nmo/l i

> have

>

> does anyone hear disagree with what i beleive is hypogonaidsm secondary??

>

> next step is to get mioney asap to get a private diagnosis and not rely on

> our health serrvice in uk that is not knoklwedhgable on the current

> testosterone issues prevalent and seem to be many years behind the real

> information out there by proffesionals who really do have this area as there

> main job.

>

> if my free testosterone i see at some point sooon will put on here but am

> i reading my shbg correctly ??

>

> am i right to say this is also low,what in effect does it being at 19 nmo/

> indicate does it indicate other things could be an issue ?

>

> as usual advice welcome

>

> regards paul

>

October 5, 2006

but if my shbg is normal then that means i cant have hypogonadism

secondary afterr all as it means my free t is going to be ok or am i

still wrong

i have problems with reading all this stuff put it this way at 40 i

still dont know how babies are acutally made in any detail yes sure i

know bits but thats it

i lose concetration and attention ,deus to the adhd and prob the low

testosterone [as i see it but the doctors dont]

so in simple few words can you re look at my figures[all of them] and

say what you see as a problem as i am now lost

as my shbg 19 nmo/ seems to sugggest my free t is going to be ok

yet my testosterone though normal and in range to the uninformed like

the uk national health service are condired low by experts and same

goes for the lh and fsh ,normal to my doctors but not to experrts.

its gettin all too much

i dont want ytestosterone for reasons stated i dont want to increase my

sexual side i want to makle that less of an issue not more

my main issues that affect my abilities are

lethargy/concetration/attention/no focouss/no ambitions

those i hope to adress by adhd meds soon to be started .

also i have only been offered the testosterone injections,this on

seeing whats said on here is also a problem as one should really be

getting the other hormones ballacned as well and my specilist will mnot

to anymore than the testosterone so if i started that then it would

only be that an nothing else.

i dont want tpo put my life in hands of someone who has no curent

knowledge of hypogonadism and testosterone /hormone issues.

as yet despite probably always having low tesstosteron i have never

broken any bones,not bad for a 40 yrs old,mind you prob down to fact i

dont do anytihng thats liklley to get me hurt ie sports/working and so

on cant do anything much sitting in front of pc all week.

but maybe my bones will suffer in future ,but at moment no TRT ,only

ADHD meds is what i want to try first

regards paul

>

> Here is what Dr. nco says about SHBG.

> " The body regulates free testosterone by the production of SHBG.

Higher SHBG reduces free testosterone. SHBG is reduced by testosterone

and other androgens, insulin, and growth hormone. SHBG is increased by

estrogens, thyroid hormone, and progesterone. The balance of these

factors determines the total SHBG production. Testosterone can also be

destroyed more quickly if liver enzymes for it are stimulated in

activity - such as in some drugs which induce certain liver enzymes.

October 5, 2006

with your total T so low and your SHBG low your Free T is not going to be

normal or high just does not work that way. You Testosterone is to low and you

feel like shit because of it. If you went on TRT you will feel better and more

then lakely you will fine you don't have ADHD. Who the hell told you you are

ADHD are you over active can't sit still have to move all the time. I don't

think so not with levels this low. Do your self a favor and see if you can get

on Testogel aka Androgel start at 5 grams do this for 2 weeks and then get

tested to be sure it's working. I don't feel doing TRT is going to turn you

into a sex crazy man 90% of men on TRT have very low libios. And when you post

your labs put the range in with it. Your Total T is so dam low in are units

your below the normal range.

Here read this Q & A from Dr. 's site. www.allthingsmale.com.

Phil

Dr. 's AllThingsMale.com --> Home | Contact Us

Office Location Dr. 's Forum A Call to Arms

Testimonials Lectures Consultations The Man Cave Reports

--> [input] search

For Those Traveling to the Man Cave

Dr. 's Forum at www.meso-rx.com

Others to Call

Testimonials Regarding Dr. 's Products and Services

Calendar of Events

Meet with Dr.

Inside the Man Cave

Reports written by Dr.

Dr. does his best to protect AAS users.

Home / FAQs

Q & A Forum with Dr at A4M HRT Forum at Mesomorphosis -->Frequent

Questions (FAQ) Online Store Rx Medications Office Location Consultations

On-Line Forms Testimonials Papers by Dr. Crisler Inside The Man Cave Links

Anti-AgingAmerican Academy of Anti-Aging Medicine

FAQs TESTOSTERONE REPLACEMENT THERAPY (TRT) FAQ'S

Q: What are the symptoms of hypogonadism ( " low testosterone " )?

Fatigue

Loss of muscle mass

Fat gain

Poor recovery

Irritability

Depression

Decreased memory

Lack of libido

Erectile Dysfunction

A problem with using these symptoms to diagnose hypogonadism is that you

cannot directly relate either the number of symptoms present, or the severity of

any of them, to the actual severity of the hypogonadism. That is why proper

evaluation by a physician specifically trained in this type of medicine, as well

as appropriate laboratory testing (much more on that in future articles), is

absolutely necessary.

Q: What diseases and conditions are associated with hypogonadism?

Cardiovascular disease

Cancer

Diabetes

Metabolic Syndrome X

Osteoporosis

Depression

Dementia (including Alzheimer's)

Erectile Dysfunction

That is a scary list, to be sure! One of the scarier conditions is Metabolic

Syndrome X which has only recently begun to receive much public attention.

Metabolic Syndrome is an insulin-insensitivity condition that is believed to be

the precursor to adult-onset diabetes. It is estimated that approximately 47

million Americans (22%) now have Metabolic Syndrome. For persons 60-69 years of

age, the prevalence rises to 42%.

Metabolic Syndrome (also called Syndrome X) is defined as the simultaneous

presence of 3 of the following 5 risk factors:

Abdominal obesity (beer belly): waist circumference greater than 40 inches in

men; 35 inches in women.

Elevated blood pressure: greater than 130/85 mmHg.

Decreased HDL (the " good " ) cholesterol: less than 40 mg/dL in men; less than

50 mg/dL in women.

Elevated triglycerides: greater than 150 mg/dL.

Elevated fasting glucose: greater than 110 mg/dL.

Left untreated, people with Metabolic Syndrome are at increased risk of

cancer, diabetes, heart disease, and erectile dysfunction. We learn more about

this condition nearly every day, but many signs point to the possibility that

HRT may help to prevent and/or delay the onset of Metabolic Syndrome. It may

even help you to partially overcome the condition.

Q: Is TRT helpful in treating these diseases and conditions?

Yes, it is not enough to recognize that low hormone levels are associated with

a given disease state or physical symp tom . It also must be shown that raising

that hormone's level reduces the risk of developing, or dramatically

improves-even eliminates--that disease or symp tom . Fortunately, scientific

studies have shown that TRT does this for every single one of the above listed

diseases AND symptoms.

Q: Is TRT dangerous?

Literally millions of men, from all over the world, have enjoyed the benefits

of TRT. To date, we have not found a single case of appropriate TRT hurting

anyone.

Q: Can TRT give me cancer?

Absolutely not. In fact, appropriate TRT has been shown to reduce your risk of

cancer, probably due to its immune system boosting benefits.

Q: What are the possible negative side effects of TRT?

Some men report some water retention. This usually subsides, but if it

doesn't, can be easily controlled by using a medication or OTC

(Over-the-Counter) supplement to lower estrogen-the usual cause of chronic water

weight gain while on TRT.

The risk of possible liver disease is listed on the package insert. But this

is a throw back to the abuse of testosterone supplementation-in other words,

taking steroids. I have never heard of appropriate TRT damaging the liver.

While the possibility of inducing, or increasing, the symptoms of BPH (Benign

Prostatic Hypertrophy) is often mentioned, numerous studies have shown this is

not the case. TRT has also been shown to not increase the risk of prostate

cancer as well.

On the subject of prostate cancer, that is one of two medical conditions which

are, at this time, an absolute contraindication (meaning a reason to withhold

treatment) to TRT. That is why doctors who administer TRT monitor prostate

health with regular PSA tests and Digital Rectal Exams. The other

contraindication is male breast cancer.

Patients on blood thinners may need to have these medications dosed

differently, as TRT also helps protect against unwanted clotting. On the other

hand, the consistency of the blood is appropriately monitored while on TRT, as a

few men will develop polycythemia (blood that is too thick)-a completely

reversible condition. In fact, TRT's ability to build up the blood is why it is

one of the treatments for anemia.

Diabetics-whether on insulin or oral medications-usually need to have the

dosages of these medications decreased, often dramatically. TRT is profoundly

effective at controlling blood sugar levels.

Patients with hypertension (high blood pressure) on a class of medications

called beta blockers may need to have their meds monitored as well.

Q: My doctor tested my testosterone level, and because it was just barely

above the bot tom of normal range, he said I do not need TRT. Is he right?

The " normal " reference range for Total Testosterone is found through

statistical means, meant to include 95% of all adult males. Yet, when tested

properly-with what is called a Bioavailable Testosterone assay-about half of all

men over the age of fifty have low testosterone . That means a significant

percentage of those included in " normal " range are actually sick with

hypogonadism (reread the list of serious diseases associated with hypogonadism).

Therefore " normal range " has absolutely nothing to do with health and happiness!

Anti-Aging experts agree that if you are experiencing the symptom s of

hypogonadism (low testosterone), even if your levels are as high as mid-range, a

course of TRT is probably warranted. If your symptoms improve or disappear

altogether, that proves you had the disease. This is known to doctors as

" therapeutic testing. "

Q: Can any adult male with low or low-normal testosterone levels get TRT?

At this time, men who have either prostate or breast cancer are deferred from

undergoing TRT. We are also careful to regularly monitor PSA levels, as well as

manually checking the prostate with a Digital Rectal Exam.

Along the way, we monitor blood levels, as a small portion of TRT patients

will have their blood become too " thick " , a condition known as polycythemia.

This can happen because testosterone supplementation stimulates the production

of red blood cells, which is why it is sometimes prescribed to treat anemia.

Beyond that, it is just a matter of finding a physician well-trained in how to

best administer this profoundly effective treatment therapy.

Q: If I go on TRT, how will it change my life?

Most men report dramatic increases in sexual performance, up to and including

a reversal of Erectile Dysfunction (ED) symptoms. They also have much more

energy, better stamina, increased muscle and decreased fat, and an improvement

in their ability to concentrate and remember things. All of a sudden they are

being active well into the evening again, enjoy great sex, can catch up to the

grandkids, and hit that golf ball 40 yards further. They tell me they have

regained their " edge " . Plus they feel they just plain look younger. And this is

in addition to the dramatic decreases in the risks for the serious diseases I

listed previously in this article.

Q: If I go on TRT, is it forever?

No, you can always go back to feeling the way you used to!

Q: Is Testosterone Replacement Therapy the same thing as doing steroids?

Good question, especially with all the press lately regarding steroids in

professional sports. Doing steroids means taking testosterone waaaaay above the

top of normal range. This is VERY bad for your health. Testosterone Replacement

Therapy (TRT), on the other hand, is merely restoring, or optimizing,

testosterone levels to healthy range. S tudies have shown that men get healthier

(and happier) as they approach the top of normal range. And they tend to stay

that way much longer.

A good analogy is the recent recommendation that a glass of wine at dinner

each night may be good for our health. But drinking a whole bottle is a

different matter entirely!

Q: What exactly do you do with TRT treatment? Shots? Pills?

There are several different methods for administering TRT: testosterone gels

and creams, patches, pills, implantable pellets and injections. Each has their

respective benefits, and shortcomings. Which testosterone delivery system to use

has as much to do with each individual's lifestyle as it does the medical

condition. That is why this decision must be made TOGETHER by the physician and

the patient.

In my professional opinion, the best two methods are the gels/creams, and

injectable testosterone.

Q: What is Anti-Aging Medicine?

It typically includes the tenets of Preventative Medicine, such as diet,

nutrition and exercise. These efforts are meant to reduce the risks of serious

diseases such as cancer, diabetes and heart disease. But it goes far beyond

that, to the optimization of hormone levels, in order to maximize health,

fitness and happiness. This includes not only testosterone, but also growth

hormone, thyroid and even adrenal hormones. In coming articles we will explore

all of these treatment modalities in depth.

This is why patients who want to maintain-or regain--their " edge " need to seek

out the care of an Anti-Aging Specialist.

Q: After recognizing that I have the symp tom s of hypogonadism you describe,

I asked my doctor about possibly getting on TRT. He told me I should not get

TRT, because it is natural for men to have their testosterone levels drop as

they age. Is that true?

You might want to respectfully ask your doctor is he/she prescribes HRT for

aging women. After all, it is " natural " for their estrogen levels to drop during

menopause, and this is what causes their profoundly uncomfortable

symptoms--which dramatically affects Quality of Life (QOL). Yet doctors

routinely prescribe estrogen replacement for them, even though this is treating

a completely " natural " condition. It has been said that female " menopause " is

like falling off from a cliff, while male " andropause " (loss of male sex

hormones) is more like rolling down a hill-it happens more slowly and

insidiously. But the dangers of hypogonadism with respect to tremendous loss of

QOL is undeniable. More so, it is associated with increased risk of

cardiovascular disease, cancer, diabetes, osteoporosis, depression, dementia

(including Alzheimer's) and Erectile Dysfunction. The fact most doctors feel it

is perfectly a cc eptable for them to treat a drop in sex hormones in women, but

not

men, may be thought of as a form of bias against men's health.

When thyroid hormones get low (hypothyroidism) we give thyroid medication.

When insulin gets too low (diabetes) we give insulin. Why should it be any

different for the sex hormones?

On the second point, there is not one shred of evidence to suggest that TRT

causes cancer. Not one. In fact, multiple studies have shown that LOW

testosterone levels are strongly associated with a higher risk, and worse form

of, cancer.

Both points demonstrate why you need a doctor who really understands this

stuff. The risk of being subjected to unnecessary disease is too great. And why

not live life to its fullest, for as long as possible?

Q: Why should I enlist the help of a genuine Anti-Aging Medicine physician to

test for hypogonadism, and administer my TRT?

In the first place, God bless any doctor who is willing to provide TRT. But

there are so many new developments in this exciting new kind of medicine that

you want someone who is specially trained in this type of therapy. That is the

only way to truly optimize one's health and fitness.

Q: Where can I research more information on this subject?

The American Academy of Anti-Aging Medicine , of which I am proudly a member

(and also lecturer and Moderator of their national and international

conferences), maintain a website resplendent with information at:

www.worldhealth.net . You can even subscribe to their free email newsletter,

which is a fascinating read, and some pretty exciting stuff!

Welcome to the cutting edge of medicine.

Q: What other services do you provide at the ALLTHINGSMALE Center for Men's

Health?

We currently provide anti-aging consultation, HRT therapy, Botox treatments

(for women and men), nutrition and supplement advice and sales. More services

are added frequently, so please explore the rest of this web site.

-->

promachief <promachief@...> wrote:

but if my shbg is normal then that means i cant have hypogonadism

secondary afterr all as it means my free t is going to be ok or am i

still wrong

i have problems with reading all this stuff put it this way at 40 i

still dont know how babies are acutally made in any detail yes sure i

know bits but thats it

i lose concetration and attention ,deus to the adhd and prob the low

testosterone [as i see it but the doctors dont]

so in simple few words can you re look at my figures[all of them] and

say what you see as a problem as i am now lost

as my shbg 19 nmo/ seems to sugggest my free t is going to be ok

yet my testosterone though normal and in range to the uninformed like

the uk national health service are condired low by experts and same

goes for the lh and fsh ,normal to my doctors but not to experrts.

its gettin all too much

i dont want ytestosterone for reasons stated i dont want to increase my

sexual side i want to makle that less of an issue not more

my main issues that affect my abilities are

lethargy/concetration/attention/no focouss/no ambitions

those i hope to adress by adhd meds soon to be started .

also i have only been offered the testosterone injections,this on

seeing whats said on here is also a problem as one should really be

getting the other hormones ballacned as well and my specilist will mnot

to anymore than the testosterone so if i started that then it would

only be that an nothing else.

i dont want tpo put my life in hands of someone who has no curent

knowledge of hypogonadism and testosterone /hormone issues.

as yet despite probably always having low tesstosteron i have never

broken any bones,not bad for a 40 yrs old,mind you prob down to fact i

dont do anytihng thats liklley to get me hurt ie sports/working and so

on cant do anything much sitting in front of pc all week.

but maybe my bones will suffer in future ,but at moment no TRT ,only

ADHD meds is what i want to try first

regards paul

>

> Here is what Dr. nco says about SHBG.

> " The body regulates free testosterone by the production of SHBG.

Higher SHBG reduces free testosterone. SHBG is reduced by testosterone

and other androgens, insulin, and growth hormone. SHBG is increased by

estrogens, thyroid hormone, and progesterone. The balance of these

factors determines the total SHBG production. Testosterone can also be

destroyed more quickly if liver enzymes for it are stimulated in

activity - such as in some drugs which induce certain liver enzymes.

---------------------------------

Talk is cheap. Use Messenger to make PC-to-Phone calls. Great rates

starting at 1¢/min.

October 5, 2006

hi my adhd aspergers and dysprraxia diagnosis are correct and i fought

for several yrs to gwet sent to the right specialisits

so yes i do have ADHD that is a fact and not disputable,though it the

lable name itslef is unimportant in factthe sypmtpns of the 3 above and

others often cross over with each other ,in reality i prefer to say

iam NEURO DIVERSE ND as we call it

the testosterone issues probably did not taake hold till puberty or

what should of been puberty the adhd etc issues were noticable by me by

about 6,my parents about 2/3 yrs old though some things were noticeale

by them from earlier than that too,and had develepmental milestone

delayed becasue of them.

adhd is not aboutn running around ,when we say hypercative it does not

mean that i for one was and am a very noisy person,quitw annoying to

others ,when i worked i wsas as well,sitting still is difficult i move

my body every minute orr so

whjere dad will sit say for some time and watch sometihng i will

constanlty be tapping/figeting/making noise and other tics i

have,inlcuding the ocassional jerk of a psart of my body

my thoughts are always going around and around and hard to just sit on

one thing for long,i forget and lose things both wirtiten things and

pyhical things often.

i have one particular hobby well obsession but even therre its still

sometihng that when wrting things for my hobby if i do more than few

minutes i make lots of errors

my sleeping has always been affected to,plus temper/behavoiurs i have

numeroue sensory and other oveloads.

do you get tired shaving and only do it once or twice a week??

if you shave do you then forget or run out of time mentally to clean

teeth have a wash??

does someone have to remind you to take a bath every 3 weeks??

do you go to ATM machine and leave either card or money in it more than

2/3 times a year

well i could list so much and yes some of its made worse by the

additional low t,that i am convined of,as knowing more adhd/aspies and

so on nowe i can see that i have some extra lethazrgy and problems some

of them dont,thoug it has to be said,i know ones closest to me also

have low t problems and other sexual genital problems too.

so i am sure that as in ADHD aspergers/dypsaxia signlas are not getting

from the brain correctly so too as i have found out on here that the

pituitary i had not heard of till this group and you say is in the

brain and this is in hypogonasim secondary not sdending the right

siglans to the testicls etc then i think these are closeyl linked

it seems that my problsm seem to often stem back to brain functioning

issues ,i did not realise till this group that that also could be to do

with my testosteone as well but hypogonadism sencondary imo shows that

to be the case

i feel the adhd and co morbids are most likley to be to do with

hormone/brain chemicals and maturity of parts of the brain and so

accounts for various issues many of us have.

but ADHD is real,as said i dont beleive in the name or label ,thats

just something a scientist gives it,in fact hans aspergers and who ever

discovered adhd were looking at similar issues,adn then someone else

dysrpaxia/tourettes etc .

many of us have more than the one diagnosis,thouh orginally it was

thought you could not have adhd and aspergers its now common theory

indeed you can

so for me lets try the adhd meds first,trt is last resort.

i dont want any sexual fucntioning i am not saying trt will make me

wanting sex all time etc but any increase to me is not what i want .

i want to be able to think clearer/cioncentrate/read a book as at

presnt i cant even read long email or magazine article and well

actually start my life ,dont know how i will suddenly get the urge to

do something with my life and cant be sure of any drugs be it trt or

adhd meds all have good and bad

but i will try and give besat to each one,one at a time,if the meds

work as they do for some then surely i wont perhaps need trt anyway.

if none work then trt is still an option

but as said the olny choice is enthantate ,there is nothing else,we

cant in uk just choose what we want my endo said this is what i

give,end of story

i wont even sdee him again as he cant give me hypogondism diagnosis and

does not really beleive i have any problems just said partial androgen

deficiney to please me

dont want to be pleased just an accurate diagnosis based on knowledge.

so diganoise i may pay for privatelyt but certainly not any trt .

regards paul

>

> with your total T so low and your SHBG low your Free T is not

going to be normal or high just does not work that way. You

Testosterone is to low and you feel like shit because of it. If you

went on TRT you will feel better and more then lakely you will fine you

don't have ADHD. Who the hell told you you are ADHD are you over

active can't sit still have to move all the time. I don't think so not

with levels this low. Do your self a favor and see if you can get on

Testogel aka Androgel start at 5 grams do this for 2 weeks and then get

tested to be sure it's working. I don't feel doing TRT is going to

turn you into a sex crazy man 90% of men on TRT have very low libios.

And when you post your labs put the range in with it. Your Total T is

so dam low in are units your below the normal range.

>

October 5, 2006

Hi Phil-

Great read!The essence of testosterone replacement. It should be

required reading at every medical university (hey, I can dream, can't

I?) I guess the slow way is to wait for more and more independant

studies to come out confirming what he's been trying to say all along.

I've also been following s posts and wish I could offer

suggestions but the additional variable about ADHD has me stumped. I

have almost no knowledge about it other than the stuff I read on the

net. My oldest nephew had ADHD when he was a small child

(hyperactive) and I think they gave him Ritalin for it. He wasn't on

it for very long and seemed to outgrow it. I sorta had the impression

it was a hit-or-miss diagnosis thing, like antidepressants. But then,

that was something like twenty years ago. I'm sure they've advanced

by then. Then again, maybe they misdiagnosed it as you suggested. I

also thought hyperactivity was a prime suspect for ADHD, so was that

why they came to that conclusion, or something else? seems more

optimistic about ADHD meds, and I wish him well, but thats a subject

I'd really rather " not go there " ; I have enough " fun " figuring out

TRT.

Rich

>

> with your total T so low and your SHBG low your Free T is not

going to be normal or high just does not work that way. You

Testosterone is to low and you feel like shit because of it. If you

went on TRT you will feel better and more then lakely you will fine

you don't have ADHD. Who the hell told you you are ADHD are you over

active can't sit still have to move all the time. I don't think so

not with levels this low. Do your self a favor and see if you can

get on Testogel aka Androgel start at 5 grams do this for 2 weeks and

then get tested to be sure it's working. I don't feel doing TRT is

going to turn you into a sex crazy man 90% of men on TRT have very

low libios. And when you post your labs put the range in with it.

Your Total T is so dam low in are units your below the normal range.

> Here read this Q & A from Dr. 's site. www.allthingsmale.com.

> Phil

> Dr. 's AllThingsMale.com --> Home | Contact Us

> Office Location Dr. 's Forum A

Call to Arms Testimonials Lectures Consultations The Man

Cave Reports

> --> [input] search

> For Those Traveling to the Man Cave

> Dr. 's Forum at www.meso-rx.com

> Others to Call

> Testimonials Regarding Dr. 's Products and

Services

> Calendar of Events

> Meet with Dr.

> Inside the Man Cave

> Reports written by Dr.

> Dr. does his best to protect AAS users.

>

> Home / FAQs

>

> Q & A Forum with Dr at A4M HRT Forum at Mesomorphosis --

>Frequent Questions (FAQ) Online Store Rx Medications Office Location

Consultations On-Line Forms Testimonials Papers by Dr. Crisler Inside

The Man Cave Links

> Anti-AgingAmerican Academy of Anti-Aging Medicine

>

> FAQs TESTOSTERONE REPLACEMENT THERAPY (TRT) FAQ'S

> Q: What are the symptoms of hypogonadism ( " low testosterone " )?

> Fatigue

> Loss of muscle mass

> Fat gain

> Poor recovery

> Irritability

> Depression

> Decreased memory

> Lack of libido

> Erectile Dysfunction

> A problem with using these symptoms to diagnose hypogonadism is

that you cannot directly relate either the number of symptoms

present, or the severity of any of them, to the actual severity of

the hypogonadism. That is why proper evaluation by a physician

specifically trained in this type of medicine, as well as appropriate

laboratory testing (much more on that in future articles), is

absolutely necessary.

> Q: What diseases and conditions are associated with hypogonadism?

> Cardiovascular disease

> Cancer

> Diabetes

> Metabolic Syndrome X

> Osteoporosis

> Depression

> Dementia (including Alzheimer's)

> Erectile Dysfunction

> That is a scary list, to be sure! One of the scarier conditions

is Metabolic Syndrome X which has only recently begun to receive much

public attention. Metabolic Syndrome is an insulin-insensitivity

condition that is believed to be the precursor to adult-onset

diabetes. It is estimated that approximately 47 million Americans

(22%) now have Metabolic Syndrome. For persons 60-69 years of age,

the prevalence rises to 42%.

> Metabolic Syndrome (also called Syndrome X) is defined as the

simultaneous presence of 3 of the following 5 risk factors:

>

> Abdominal obesity (beer belly): waist circumference greater than

40 inches in men; 35 inches in women.

> Elevated blood pressure: greater than 130/85 mmHg.

> Decreased HDL (the " good " ) cholesterol: less than 40 mg/dL in

men; less than 50 mg/dL in women.

> Elevated triglycerides: greater than 150 mg/dL.

> Elevated fasting glucose: greater than 110 mg/dL.

> Left untreated, people with Metabolic Syndrome are at increased

risk of cancer, diabetes, heart disease, and erectile dysfunction. We

learn more about this condition nearly every day, but many signs

point to the possibility that HRT may help to prevent and/or delay

the onset of Metabolic Syndrome. It may even help you to partially

overcome the condition.

> Q: Is TRT helpful in treating these diseases and conditions?

> Yes, it is not enough to recognize that low hormone levels are

associated with a given disease state or physical symp tom . It also

must be shown that raising that hormone's level reduces the risk of

developing, or dramatically improves-even eliminates--that disease or

symp tom . Fortunately, scientific studies have shown that TRT does

this for every single one of the above listed diseases AND symptoms.

> Q: Is TRT dangerous?

> Literally millions of men, from all over the world, have enjoyed

the benefits of TRT. To date, we have not found a single case of

appropriate TRT hurting anyone.

> Q: Can TRT give me cancer?

> Absolutely not. In fact, appropriate TRT has been shown to reduce

your risk of cancer, probably due to its immune system boosting

benefits.

> Q: What are the possible negative side effects of TRT?

> Some men report some water retention. This usually subsides, but

if it doesn't, can be easily controlled by using a medication or OTC

(Over-the-Counter) supplement to lower estrogen-the usual cause of

chronic water weight gain while on TRT.

> The risk of possible liver disease is listed on the package

insert. But this is a throw back to the abuse of testosterone

supplementation-in other words, taking steroids. I have never heard

of appropriate TRT damaging the liver.

> While the possibility of inducing, or increasing, the symptoms of

BPH (Benign Prostatic Hypertrophy) is often mentioned, numerous

studies have shown this is not the case. TRT has also been shown to

not increase the risk of prostate cancer as well.

> On the subject of prostate cancer, that is one of two medical

conditions which are, at this time, an absolute contraindication

(meaning a reason to withhold treatment) to TRT. That is why doctors

who administer TRT monitor prostate health with regular PSA tests and

Digital Rectal Exams. The other contraindication is male breast

cancer.

> Patients on blood thinners may need to have these medications

dosed differently, as TRT also helps protect against unwanted

clotting. On the other hand, the consistency of the blood is

appropriately monitored while on TRT, as a few men will develop

polycythemia (blood that is too thick)-a completely reversible

condition. In fact, TRT's ability to build up the blood is why it is

one of the treatments for anemia.

> Diabetics-whether on insulin or oral medications-usually need to

have the dosages of these medications decreased, often dramatically.

TRT is profoundly effective at controlling blood sugar levels.

> Patients with hypertension (high blood pressure) on a class of

medications called beta blockers may need to have their meds

monitored as well.

> Q: My doctor tested my testosterone level, and because it was

just barely above the bot tom of normal range, he said I do not need

TRT. Is he right?

> The " normal " reference range for Total Testosterone is found

through statistical means, meant to include 95% of all adult males.

Yet, when tested properly-with what is called a Bioavailable

Testosterone assay-about half of all men over the age of fifty have

low testosterone . That means a significant percentage of those

included in " normal " range are actually sick with hypogonadism

(reread the list of serious diseases associated with hypogonadism).

Therefore " normal range " has absolutely nothing to do with health and

happiness!

> Anti-Aging experts agree that if you are experiencing the symptom

s of hypogonadism (low testosterone), even if your levels are as high

as mid-range, a course of TRT is probably warranted. If your symptoms

improve or disappear altogether, that proves you had the disease.

This is known to doctors as " therapeutic testing. "

> Q: Can any adult male with low or low-normal testosterone levels

get TRT?

> At this time, men who have either prostate or breast cancer are

deferred from undergoing TRT. We are also careful to regularly

monitor PSA levels, as well as manually checking the prostate with a

Digital Rectal Exam.

> Along the way, we monitor blood levels, as a small portion of TRT

patients will have their blood become too " thick " , a condition known

as polycythemia. This can happen because testosterone supplementation

stimulates the production of red blood cells, which is why it is

sometimes prescribed to treat anemia.

> Beyond that, it is just a matter of finding a physician well-

trained in how to best administer this profoundly effective treatment

therapy.

> Q: If I go on TRT, how will it change my life?

> Most men report dramatic increases in sexual performance, up to

and including a reversal of Erectile Dysfunction (ED) symptoms. They

also have much more energy, better stamina, increased muscle and

decreased fat, and an improvement in their ability to concentrate and

remember things. All of a sudden they are being active well into the

evening again, enjoy great sex, can catch up to the grandkids, and

hit that golf ball 40 yards further. They tell me they have regained

their " edge " . Plus they feel they just plain look younger. And this

is in addition to the dramatic decreases in the risks for the serious

diseases I listed previously in this article.

> Q: If I go on TRT, is it forever?

> No, you can always go back to feeling the way you used to!

> Q: Is Testosterone Replacement Therapy the same thing as doing

steroids?

> Good question, especially with all the press lately regarding

steroids in professional sports. Doing steroids means taking

testosterone waaaaay above the top of normal range. This is VERY bad

for your health. Testosterone Replacement Therapy (TRT), on the other

hand, is merely restoring, or optimizing, testosterone levels to

healthy range. S tudies have shown that men get healthier (and

happier) as they approach the top of normal range. And they tend to

stay that way much longer.

> A good analogy is the recent recommendation that a glass of wine

at dinner each night may be good for our health. But drinking a whole

bottle is a different matter entirely!

> Q: What exactly do you do with TRT treatment? Shots? Pills?

> There are several different methods for administering TRT:

testosterone gels and creams, patches, pills, implantable pellets and

injections. Each has their respective benefits, and shortcomings.

Which testosterone delivery system to use has as much to do with each

individual's lifestyle as it does the medical condition. That is why

this decision must be made TOGETHER by the physician and the patient.

> In my professional opinion, the best two methods are the

gels/creams, and injectable testosterone.

> Q: What is Anti-Aging Medicine?

> It typically includes the tenets of Preventative Medicine, such

as diet, nutrition and exercise. These efforts are meant to reduce

the risks of serious diseases such as cancer, diabetes and heart

disease. But it goes far beyond that, to the optimization of hormone

levels, in order to maximize health, fitness and happiness. This

includes not only testosterone, but also growth hormone, thyroid and

even adrenal hormones. In coming articles we will explore all of

these treatment modalities in depth.

> This is why patients who want to maintain-or regain--their " edge "

need to seek out the care of an Anti-Aging Specialist.

> Q: After recognizing that I have the symp tom s of hypogonadism

you describe, I asked my doctor about possibly getting on TRT. He

told me I should not get TRT, because it is natural for men to have

their testosterone levels drop as they age. Is that true?

> You might want to respectfully ask your doctor is he/she

prescribes HRT for aging women. After all, it is " natural " for their

estrogen levels to drop during menopause, and this is what causes

their profoundly uncomfortable symptoms--which dramatically affects

Quality of Life (QOL). Yet doctors routinely prescribe estrogen

replacement for them, even though this is treating a

completely " natural " condition. It has been said that

female " menopause " is like falling off from a cliff, while

male " andropause " (loss of male sex hormones) is more like rolling

down a hill-it happens more slowly and insidiously. But the dangers

of hypogonadism with respect to tremendous loss of QOL is undeniable.

More so, it is associated with increased risk of cardiovascular

disease, cancer, diabetes, osteoporosis, depression, dementia

(including Alzheimer's) and Erectile Dysfunction. The fact most

doctors feel it is perfectly a cc eptable for them to treat a drop in

sex hormones in women, but not

> men, may be thought of as a form of bias against men's health.

> When thyroid hormones get low (hypothyroidism) we give thyroid

medication. When insulin gets too low (diabetes) we give insulin. Why

should it be any different for the sex hormones?

> On the second point, there is not one shred of evidence to

suggest that TRT causes cancer. Not one. In fact, multiple studies

have shown that LOW testosterone levels are strongly associated with

a higher risk, and worse form of, cancer.

> Both points demonstrate why you need a doctor who really

understands this stuff. The risk of being subjected to unnecessary

disease is too great. And why not live life to its fullest, for as

long as possible?

> Q: Why should I enlist the help of a genuine Anti-Aging Medicine

physician to test for hypogonadism, and administer my TRT?

> In the first place, God bless any doctor who is willing to

provide TRT. But there are so many new developments in this exciting

new kind of medicine that you want someone who is specially trained

in this type of therapy. That is the only way to truly optimize one's

health and fitness.

> Q: Where can I research more information on this subject?

> The American Academy of Anti-Aging Medicine , of which I am

proudly a member (and also lecturer and Moderator of their national

and international conferences), maintain a website resplendent with

information at: www.worldhealth.net . You can even subscribe to their

free email newsletter, which is a fascinating read, and some pretty

exciting stuff!

> Welcome to the cutting edge of medicine.

> Q: What other services do you provide at the ALLTHINGSMALE Center

for Men's Health?

> We currently provide anti-aging consultation, HRT therapy, Botox

treatments (for women and men), nutrition and supplement advice and

sales. More services are added frequently, so please explore the rest

of this web site.

>

AllThingsMale.com

October 6, 2006

I think what your calling ADHD we call here ADD I am on Concerta 36mgs a

day my Dr. gave it to me to help with the Fatigue but I was on TRT at the time I

started it. I also feel you should have your Morning Cortisol levels checked it

low this can cause a lot of the things you feel. For me it's all from a head

injury that damaged my Pituitary so I am low on DHEA, Cortisol, Thyroid, IGF- 1,

Testosterone and Glucose. When I started on Concerta my brain fog and fatigue

got better but not 100%. You do need to do what you feel comfortable with and

I do know you can get the gels in the UK. Have you been to this site.

http://www.androids.org.uk/

Go there and send Nick O' Hara a Email if you need help with anything he

is a great guy and can hook you up with a dam good Dr.