Age Management Physician New to the Forum- Happy to Help!

[efete1]

Hello all

I am an active age management/preventive medicine physician in Ohio. I am new to this forum and wanted to say "Hi" and introduce myself. I am looking forward to making some new connections and helping clients/patients/and other professionals on this forum.

I practice based on what the literature tells me to and have learned from the best out there. I focus on hormone replenishment/interventional endocrinology, as well as nutrition and fitness. I also do Regenerative Medicine with PRP and more.

Looking forward to offering any advice and making some friends!

Have a great week!

Eric Fete, DO

 

[captain]

I would like to hear some things about you. Where are you located in Ohio? Are you cash only or do you take insurance? Do you Prescribe HCG with Testosterone? I have seen many on the forums looking for a Doctor in Ohio and they would probably like to hear what you have to offer.

 

[Gene Devine]

Let's be careful that this thread doesn't become a promotional advertisement for his clinic but we do welcome knowledgable members and professionals as well.

 

[FeelingLost]

Let's be careful that this thread doesn't become a promotional advertisement for his clinic but we do welcome knowledgable members and professionals as well.

Gene does this forum have a TOS (terms of service) with specific rules for vendors?

 

[Gene Devine]

Gene does this forum have a TOS (terms of service) with specific rules for vendors?

Yes: https://www.excelmale.com/forum/showthread.php?297-Excel-Male-Code-of-Conduct

Unless Admin or Moderator approved there can be no self promotion on EM or our FB Group as well.

Very important.

 

[efete1]

Good morning.

Thanks for the note. I am in Columbus, OH. Yes I prescribe Test, hcg, etc. I am fully licensed/boarded and prescribe anything that I feel is in the best interest of my patients. My hormone patients are typically all cash due to the tight/restrictive medico-legal environment here in Ohio; no issues with that. I do bill insurance for other some services (other procedures, some labs, etc). I will soon be launching an online platform for education, products etc. I won't give any more details unless asked so as not to upset anyone about promotion. That is not my goal- my goal is to be a resource for other colleagues/clients/patients. I practice EBM (evidence based medicine)- I do what works and is proven in the literature.

Have a great week and Thanksgiving everyone!!

Dr. Eric

 

[baughts]

Eric Fete, DO
I have read several articles on taking Metformin for longevity even if you do not have diabetes. What is your take on this.

 

[efete1]

Metformin is an interesting drug with many uses and benefits. If you have any hint of insulin resistance it's a no brainer for most. However if you have your nutrition, exercise, and hormones dialed in there really is no need to add it. If it's just for longevity only, there may indeed be a benefit but again the trials/studies needed to prove this have not been done. There are some that have concerns about mitochondrial damage from long term use. It may be worth using for 6 months at a time and then stopping for a few months.
A study titled "Targeting Aging with Metformin," or "TAME" for short, began in 2015, and will be looking at at men and women over the age of 60. It won't conclude for another five years, so we will have to wait and see what it shows in regards to long term use, longevity effects etc.

Other options to enhance AMPK, increase longevity etc without any concern for side effects would be the use of Gynostemma, and intermittent fasting.

Happy Thanksgiving!

Dr. Eric

 

[efete1]

Hi there,
First off great job on what you have done already!
I don't see the glucose so not sure on that. Metformin may help if you do have some insulin resistance but you may not need it yet. Your numbers aren't too bad and will likely get better with additional tweaks. HDL responds best to exercise (esp. cardio). Nicain is a great OTC for HDL and triglycerides ( and more) and it's cheap. Don't take too much too fast. I would also recommend a quality fish oil supplement.
Testosterone can be bumped (you mentioned you are new to this) as can the DHEA. I would stop the Anastrozole, no need for it at this point- your Estrogen is on the low side. This (Anastrozole is often overused). Estrogen is beneficial for lipids and much more.
What is your free T 3?
I would tweak the T and DHEA, add the fish oil and Niacin, and bump up the exercise and see how you do. Send more info on the diet; always tweaks that can be made there too. Overall you're doing very well!

Dr. Eric

 

[efete1]

Thanks for sending! Again great job on the consistency!
I would add more healthy fats, those are vital for many functions, cognition, hormones, and much more. Think avocados, almonds, quality olive and coconut oil etc.
The nipple pain you felt is a type of gyno but not the kind that most people think of- this type is usually remedied surgically. AI may help short term but the long term effects of AI's are very detrimental (bone loss, loss of cardiovascular protection, less libido etc).
If your prolactin level stays high your doc may need to get an MRI to rule out a prolactin secreting mass. Have you ever sustained any head trauma?

Your cholesterol isn't too bad. Some studies show that older men actually have increased mortality with levels that are too low. The more important thing is the level of inflammation in your body and the cholesterol sub types (advanced testing such as the NMR Lipid panel etc). You can check all this with such tests as the Lp PLA-2, apo A and apo B, Lp(a), hs-CRP, and oxidized LDL, LDL P (particle number), and small LDL number.

The Niacin may be good to add to bump the HDL if that is a concern. Enduracin is an inexpensive OTC version. week 1 take 500mg once a day, week 2 take twice a day, week 3 take 2 in am and 1 in pm - can increase / titrate as needed - you may need less, or more. Take with food (and with fish oil to avoid any flushing. may need to add aspirin as well to avoid the flush).


Dr. Eric

 

[efete1]

Great!

No problem- feel free to reach out anytime!

Have a great week

Dr. E

 

[Roguejim]

Did the doctor mean nicotinic acid rather than niacinamide, or does it matter?

 

[Vince Carter]

Hello all

I am an active age management/preventive medicine physician in Ohio. I am new to this forum and wanted to say "Hi" and introduce myself. I am looking forward to making some new connections and helping clients/patients/and other professionals on this forum.

I practice based on what the literature tells me to and have learned from the best out there. I focus on hormone replenishment/interventional endocrinology, as well as nutrition and fitness. I also do Regenerative Medicine with PRP and more.

Looking forward to offering any advice and making some friends!

Have a great week!

Eric Fete, DO

Dr Eric I would like to hear any thoughts and experience you have to managing E in a low SHBG guy, like myself. I typically run SHBG of ~12-15. We've started to understand and embrace (with Dr Crisler guidance) that low SHBG = (very) high Free T which in turn = (very) high Free Estrogen. Perhaps these guys needing to have Free T not exceeding the lab range or >3% and much lower Total T to not be overrun with Estrogen.

20mg/D Cyp (down from 28 to 24 and now 20mg)
200iu HCG once per week
.25mg EOD Anastrozole
No DHEA
No Preg

LC/MS/MS 41
Estradiol, Free 1.04 (<0.45, highest this one has ever been)
Estradiol 47 (<29, (standard test))
TT: 1105
FT: 284.6 (35-155)
DHT, Free 3.78 (1.00-6.20)
DHT LC/MS/MS 36 (16-79, 36 is about my norm)

After this set of labs we reduced Cyp to 16mg/D trying to get the Free T to come down.