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I am wondering if this is also why many men do very well on the newer compounded topicals applied to the scrotum. the newer higher strength versions need less cream (less messy) and deliver lots of T. Higher DHT more libido, better mood, and because you apply them 2 times a day, (morning and 4...

some others here may be more qualified to make an assessment, but why are you so concerned about keeping your estrogen so low? People forget it provides many good benefits, and at the numbers are you seeing is so low, you are very unlikely to see any adverse events. You could well be spending...

You may want to have a thyroid panel run, but sometime's the numbers don't always provide the answer you need. Meaning, sometime's things like TSH and t4 or even T3 numbers can be in the therapeutic window, but you still feel lousy. If those numbers are are all at the more aggressive end of the...

finasteride is not a good drug for men. period. When you think about it, it concentrates in the prostate, where it does a lot of damage by shutting down T or DHT effects in penile tissue. Evidence shows it turns your penis into fat, and kills erections. nuff said.

Yes. She is in the DC area and does concierge medicine via zoom or internet videos. She does it all. Hormonal therapy, ED treatments like shockwave, meds, whatever path you need to follow. She does not judge folks and she is not afraid to be aggressive, (she was who told me for example its ok to...

Using any of the injectables with lidocaine, may make the discomfort in injecting, or if you had pain on erection with Trimix, lessen, but when you think about what lidocaine does, even in a small amount, it will deaden the nerves in your penis too. I.E. your penis not only feels less pain, but...

Please see my amended post. the last paragraph. I needed to correct myself. For some reason I had difficulty logging in the last couple days. sorry.

telmisartan is not a diuretic. It may, as many of the ARB's have done, be combined in the same pill or tablet, with a diuretic. Usually in the US, that is done with hydrochlorothiazide a well know potassium sparing diuretic. All the ARB's work the same way, and alll are effective. Candisartan...

Clearly, this person would likely benefit from HRT. However, I would also suggest having thyroid testing done. TSH, and free T3 and free T4. Based on the reported symptoms, perhaps even antibodies for Hashimoto's...achy bones and especially achy joints can often be a hallmark of Hashimoto's.

count me as one of those people who do better with free T3 midrange or higher. Hashimoto's has its way with me regularly.

you probably wake up at night with wood now, because you weren't getting nocturnal work before. its sounds like possibly you are or were sitting on the edge of getting ED. In other words, you could get erections before, but didn't get nocturnal erections, which is a warning sign of coming ED...

Perhaps you need a sex therapist, instead of a new "stack". If virtually nothing you have tried works, and you are neurologically ok, then it's about all that's left. good luck.

I am not sure why you would have been given finasteride, but it has come under a lot of fire from those in the know in the last few years. Basically, it's a penis killer. If you are having urinary urgency symptoms from BPH, there are other options I would explore first. talk to your doc, he or...

I have been on 10mg per day for over a year with no issues. The key is if you have any of the side effects adverse events that some have. If not, and if needed, you can comfortably take 10 mg a day with Dr approval. It may also help lower your BP a little if you are hypertensive.

In my case, having more severe post radiation prostate cancer therapy related ED, and having hypertension from hematocrit and hemoglobin at or above the high normal limits, (yes its being addressed and responding well) adding in Terazosin 2 mg bid, in addition to taking 10 mg of Tadalafil daily...

I started on creams although my levels were not as low as yours. You do not want to "blast" yourself with T. Start out on a larger Topiclick and use ! click twice a day 12 hours apart. I hope you have checked more of you numbers than just Total T. You need to know free T especially. Also, how...

thanks for posting this interview. It is full of great information. As a 64 yr old who has struggled with ED, and delayed ejaculation post 6 yrs prostate cancer treatment and being followed by a community urologist who didn't have a clue and left me on finasteride for years, I am fortunate to be...

If you have hypertension with the elevated hematocrit and hemoglobin you need to reduce those numbers sooner than later, but it is paramount to keep the BP under good tight control until the docs order blood dump, or you can donate. Your numbers for those two markers are likely related directly...

First, regarding your e2. I think Nelson would agree as well, messing with your e2 won't likely help your current situation, regarding weight loss, etc. In fact, we know estrogen is what provides the positive impact in T replacement therapy, regarding cardiac protection. Ever wonder why very few...

See a cardiologist pronto. You may not be an emergency waiting to happen and likely are not, however, instead of feeling like a ticking time bomb, get the opinions of an expert. A cardiologist is trained, spent decades learning to do this type of care. They will tell you if you need rehab, if...

See a cardiologist pronto. You may not be an emergency waiting to happen and likely are not, however, instead of feeling like a ticking time bomb, get the opinions of an expert. A cardiologist is trained spent decades learning to do this type of care. They will tell you if you need rehab, if you...

I would still suggest a little more in depth testing for thyroid. Minimally, free T3 and Free T4. Your TSH is in the bottom quartile of the window for your lab, suggesting your Axis is saying to your thyroid you are making plenty of T4 (which gets converted to T3) slow down some. But, you need...

Definitely test thyroid. I am (low) hypothyroid and I can tell you, no matter how much sleep you get, you never feel really rested. When you start on medication, you will feel a huge improvement in energy levels and you feel. Your sleep symptoms sound a lot like mine before treatment. If yours...

If you have not tested your thyroid functions, that may be a good place to start. Poor or hypothyroid function will leave you feeling zapped, tired, out of sorts, and crappy with flue like aches and pains at times, cycles of diarrhea and constipation, thinning hair, and more. Its a nasty cycle.

I am also hypo thyroid and have been taking T replacement for over a year. I have no issues with libido, and have had nothing but great libido since I started the T replacement therapy. You will have a very difficult time finding any good data suggesting high E2 is the cause of low libido...

You (or someone) questioned if the creams are able to provide enough T replacement. I can absolutely say the newer compounded creams supply enough and more. My total T levels went in excess of 2,000 ng/dl on bid cream usage. Why I took that much, is another question, needless to say, once I saw...

By labs, TSH, T4 and free T4, T3 and Free T3 anything else?

How did you decide how much of each to dose? there are variables, that are not easily known, like how much of the T4 does your body actually convert to T3?

I am not familiar with synthetic T4/T3 combination? I know of both, but not combined.

If you are using caverject, talk with your doc about Tri mix. It is a mixuture of the alpostadil prostaglandin and vasodilators that work well, but are not as potent as a large dose of only prostaglandin. The alpostadil also has a deserved reputation for causing some aching and pain tenderness...

What is your LDL and HDL, and the ratio? There are specific guidelines, that show what the HDL should be, or rather, by having it below a certain number, you reduce risk. If yours is already low, I would ask her how its going to reduce my risk? In addition, the ratio of HDL to LDL also can show...